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Scope: The intent of this Request for Proposal is to enter into a contract to provide Mobile MRI and Technologist Services to include all the necessary personnel, supervision, equipment, transportatio... Scope: The intent of this Request for Proposal is to enter into a contract to provide Mobile MRI and Technologist Services to include all the necessary personnel, supervision, equipment, transportation, materials, supplies and training to perform the services as specified herein. Service shall be performed at any West Texas VA Healthcare Facility, including both owned and/or leased facilities, main and/or community-based outpatient clinics where indicated. Summary of Requirement: The West Texas Healthcare System is seeking a 12-month Base, plus 4 (four) 12-month Option Periods, contract for a mobile MRI and associated service agreement and Technologist staffing. The mobile MRI will be placed on an as-needed basis for delivery or move within 10 days, to remain in a single location no less than 6 months. Delivery and Set-up of Contractor Equipment: The Contractor shall be responsible for proper installation/set-up of the Contractor's furnished equipment including the mobile coach. Installation/set-up shall be accomplished in accordance with industry standards, all OSHA regulations and applicable manufacturer's recommendations. The Contractor shall provide a mobile 1.5T MRI coach and MRI Technologists Services at station 519 (West Texas Healthcare System), in accordance with the SOW (Statement of Work). Schedule: Services shall be required five (5) days per week, except on federal holidays. Hours of Service: Contractor's mobile unit and/or personnel shall be on site to perform exams eight (8) hours per day, Monday - Friday, between the hours of 7:30 am and 4:30 pm. The first MRI will begin at 7:30 am with the last patient being seen such that the exam is completed no later than 4:30pm. Pro-rated Monthly Rental Fee: The Contractor shall prorate the monthly rental fee when MRI coach is not functioning in accordance with prescribed guidelines. The monthly fee shall be prorated based on the number of hours the coach is out of service during regularly scheduled clinic hours M-F, 7:30am – 4:30pm. The Contractor shall include the hourly rate in the space provided below: Contractor's Responsibilities: The Contractor shall be responsible for the following daily functions: Contractor shall be responsible for the transportation of the Mobile MRI coach to and from WTVAHCS. Cost of transportation shall be included in the monthly rate. Big Spring facility is gated and locked after-hours. The facility is open from 6:30 am through 6 pm Monday through Friday for removal of trailer for other assignments. Delivery and Set-up of Contractor Equipment: The Contractor shall be responsible for proper installation/set-up of the Contractor's furnished equipment including the mobile trailer. Installation/setup shall be accomplished in accordance with industry standards, all OSHA regulations and applicable manufacturer's recommendations. Transmit completed electronic data after each exam. Ensure that all of the day’s exam data is completely transferred to the West Texas VA Healthcare System computer systems. All patient information required for Contractor's records shall be secured in accordance with HIPAA guidelines. All connections from the trailer to West Texas VA Healthcare System site/property are properly disconnected from trailer when moved from the site. Any temporary site preparations are removed upon completion of services. Contractor shall ensure mobile MRI is maintained in optimum working condition to ensure the highest level of patient safety at all times. Fire extinguisher to be supplied by the vendor. Vendor shall provide MRI compatible wheelchair, stretcher and O2 tank. Maintenance documents shall be made available to the West Texas VA Healthcare System upon request. Contractor shall ensure each patient arriving for mobile MRI exam has a signed MRI order for services. MRI tech must complete the final MRI Screening Assessment which is incorporated in the patient’s electronic medical record. Contractor shall use appropriate screening devices to ensure patient has no ferro-magnetic materials on or in receive his/her body. Contractor shall be responsible for adhering to all Federal regulations regarding patient care, patient safety, medical practice and operation of mobile MRI. Contractor shall provide a copy of a current, comprehensive MRI Safety Program policy to which each technologist is expected to comply. MRI Technologist is required to complete West Texas VA Healthcare System or analogous MRI Safety Training yearly. Contractor shall be responsible for patient while on the mobile unit and during the entire scanning procedure up to the patient's release. In the event a patient is injured while in Contractor's care, Contractor shall immediately notify the assigned nurse or a designated VA physician and complete a written report. Environment of Care Rounds shall be conducted quarterly by the local site COR and West Texas VA Healthcare System Administrator. All identified deficiencies shall be corrected by the Contractor prior to the next scheduled day of service. Contractor shall be responsible for providing 2 qualified MRI Technologists to perform services defined herein. The MRI Technologists shall be required to provide scanning services as well as training on the full operation of the Mobile MRI unit. Training shall be provided to the assigned West Texas VA Healthcare System technical personnel at no additional cost to the Government. If the MRI Technologist is unable to come in to work as per the schedule, an alternate MRI Technologist is available to cover the shift to avoid having to reschedule patients. All MRI Technologists must complete the credentialing requirements established by West Texas VA Healthcare System. MRI Technologist shall attend the quarterly MRI Safety Committee meeting. Comply with VHA Directive 1105.05 Magnetic Resonance (MR) Safety, WTVAHCS MRI Policy and Procedures and MRI scanning protocols. 5. Delivery Locations: See below for location of West Texas VA Healthcare System sites of care. The delivery locations include but are not limited to these locations. If new VA locations within the geographic boundaries of West Texas VA Healthcare System (such as a new clinic in Abilene) are added during the duration of the contract, those will presume to be included as potential deployment locations for a mobile MRI as well, provided that they are affiliated with station 519. George H. O'Brien, Jr., Department of Veterans Affairs Medical Center 300 Veterans Boulevard Big Spring, TX 79720-5566 Abilene VA Clinic 3850 Ridgemont Drive Abilene, TX 79606-2728 Colonel Charles and JoAnne Powell VA Clinic 4240 Southwest Boulevard San Angelo, TX 76904-5634 Fort Stockton VA Clinic 1205 North Sycamore Street Fort Stockton, TX 79735-4122 Hobbs VA Clinic 1301 North Turner Street Hobbs, NM 88240-8446 Wilson and Young Medal of Honor VA Clinic 8050 East Highway 191 Odessa, TX 79765-8615 8. Magnetic Resonance Imaging (MRI) Mobile Device Salient Characteristics: Contractor shall make whatever adaptations are necessary so that the Contractor's equipment is compatible with the West Texas Healthcare System data network as specified in Paragraph 16, Telecommunications. Salient characteristics Details Magnet strength 1.5 Tesla Minimum Bore width (cm) 70cm Minimum bore depth (cm) 130cm Minimum slew rate (T/m/s) 125 Minimum number of channels 48 Maximum patient table load capacity for vertical and horizontal table movement (lbs) 550 Maximum system weigh (lbs) 10,000 Helium consumption Zero Helium boil-off technology Min patient comfort requirement Short and wide bore for greater patient comfort and easier access for various patient sixes Gradient system XJ Gradients with high performance capable of handling advanced imaging techniques RF Technology TIM 4G 9Toal Imaging Matrix) technology, allowing flexible coil combinations and faster imaging Coil Technology Up to 204 coil elements, allowing for whole body imaging without patient repositioning Imaging speed Up to 48 channels supported with Tim 4G, enabling faster scans and higher throughput Image quality High spatial and temporal resolution, with advanced features, post processing and workflow optimization tools Patient handling Comfortable positioning for long exams, with respiratory and cardiac gating options Application range Neurology, musculoskeletal, cardiovascular, Ortho, Oncology, MRA, Elastography, Spectroscopy, Phase contrast MRI and flow analysis, parametric prostate imaging, high intensity focused ultrasound with the flexibility to expand due to different facility provider requirements Advanced Imaging Techniques Diffusion weighted imaging (DWI), functional MRI (fMRI), cardiac imaging, MR spectroscopy, etc. Environment Energy efficiency and reduced operating costs Installation space Mobile trailer installation capable; Semi-trailer truck equipped with stabilizing shocks to prevent disruption of the machine, compact design with low space requirements ideal for a mobile trailer Operator workflow Intuitive user interface, customizable protocols, and easy data management Connectivity DICOM compliant integrated with hospital information system (HIS) and Picture Archiving (PACS) Upgradeable Must be upgradeable to newer software and hardware innovations Safety features Advanced patient monitoring, acoustic noise reduction, and patient emergency systems. Safety system for magnet quenching and emergency shutdown, to include the following: Alarms for low cryogen levels, temperature limits, scans in progress Indicators for cryogen levels Heat sensor shut offs for room temperature problems. Oxygen monitor in gantry room. Table requirement Motorized Detachable Adjustable height Stepping capable UPS requirement Maintains full functionality of the system for a minimum of 30 minutes during a power outage Coil requirement Imaging of the Torso, knee, shoulder, head/spine/array, neuro vascular, run-off, foot/ankle, wrist, elbow, cardiac, breast, prostate imaging, functional MRI head, carotid, endorectal, periphery vascular, extremity, flexible, transmit/receive, adjustable neurovascular head, whole body imaging Security/Connectivity requirements OEM supported operating system. Latest DICOM print, store, commit, structured report (SR) and modality worklist. Wireless connectivity to VA network – Compatible with 802.11b/g/n and FIPS 140-2 or FIPS 140-3 compliant Encrypted hard drive. PACS compatibility – Change Healthcare Integration to Advanced Visualization Systems Chiller requirement Chiller meeting or exceeding MRI needs Cryogen requirement Cryogens (Vendor expected to provide and install all cryogens.) Phantom requirements All phantoms required for proper calibration and performance verification (Vendors are expected to provide phantoms for all system requirements and options identified in this document that require phantoms.) Patient comfort/entertainment package Integrated music system, to include the following: Control room controls Speech communication for patient direction Speakers in both the exam room and control room Headphone jack on patient table MRI-safe headphones Shielding requirement Active Shielding Workstation requirement Min acquisition workstation monitor size of 19in Minimum acquisition workstation hard drive space 200 [GB] Minimum number of processing/reading workstations: 2 Minimum processing/reading workstation monitor size 19 [in] Minimum processing/reading workstation hard drive space 200 [GB] Additional technology specifications Compressed sense technology Motion correction technology Helium save technology. Noise reduction technology Power conditioning Vector ECG(VCG), respiratory and peripheral pulse gating/triggering Advanced Exam planning technology Geometry linking (multi station exams) Real time MIP, MPR, AND 3D surface rendering Advanced MR viewing environment, processing, and image generation. Patient specific shimming Dixon type technology for body, neuro, and musculoskeletal imaging Advanced non-contrast MRA imaging technology 3D FSE based sequence for isotropic resolution in all contrasts. Bolus tracking system Heavy duty wide patient restraints Patient positioning and support aids Video camera system for monitoring inside the exam room from the control room MRI-compatible contrast injector Operating system must be Windows 10 or newer The scanner must be able to scan the cervical, thoracic, and lumbar spines continuously without requiring patient movement. The Mobile MRI unit shall be ready for use regardless of outside environmental conditions. The Mobile MRI unit shall maintain a temperature to assure proper operation of the scanner and provide for patient comfort. The Mobile MRI unit shall include a private dressing area with secured cabinets for patient use. Contractor shall provide an MRI-compatible Automatic External Defibrillator (AED). The system must contain the minimum characteristics: AED Unit with LCS Screen showing voice prompt messages, device advisory messages, elapsed time, shock count and chest compression graph, Operator's Guide and Carrying Case; Two (2) Sets of CPR-D Pads, one piece defibrillation and CPR system with compression, depth and rate sensors, supplies with gloves, barrier mask, scissors, razor, wet wipes and dry wipes. Trailer space requirement (based on max system dimensions) Location Requirement Width (cm) Depth (cm) Height (cm) Weight (cm) Examination Room Magnet and Helium 210 150 220 3200 Magnet, gradient coils body coil, table and covers 250 450 225 5000 Min room height clearance 245 Control Room Workplace table and monitor 130 90 120 Equipment room Cabinets with system controls, RF system, gradient power system image processor 170 70 200 1500 9. MRI Technologist Staffing Salient Characteristics: a. The Contractor's Technologists shall possess a current American Registry of Radiologic Technologists (ARRT) license, certified in MRI through ARRT and Basic Life Support (BLS) certified. A copy of all applicable operators’ license/certifications shall be provided with the proposal along with a copy of the updated license immediately upon renewal. The Contractor shall ensure that a copy of the technologist’s current license is provided to the local COR for inclusion in the West Texas VA Healthcare System 6-part folder at all times. b. The Contractor shall be responsible to ensure that Contractor employees providing work on this contract are fully trained and completely competent to perform the required work. Evidence of the Contractor’s Technologist’s competency review shall be provided with the proposal. Competency checklists must contain evidence of supervisory review at least annually and must contain the written signature of the supervisory official performing the review. A current copy of the employee’s competency checklist shall be maintained in West Texas VA Healthcare System 6-part folder at all times. Competency checklists shall be resubmitted to West Texas VA Healthcare System each time the checklist is updated, no more than 12 months beyond the original date of review. c. The Contractor shall be required to maintain documentation and provide copies, with their proposal, of the following for each employee working under the contract: (1) credentials and qualifications for the job (2) a current competency assessment checklist (an assessment of knowledge, skills, abilities and behaviors required to perform a job correctly and skillfully; includes age-specific knowledge and skills required to provide care for certain patient populations, as appropriate.) (3) a listing of relevant continuing education for the last two years. (4) health examination records of all individuals performing work under this contract to include: (a) Annual TB Skin Test and recent (within the last year) chest X-ray if there is a history of positive TB skin test Evidence of Hepatitis B immunity (hepatitis immune titer, if provider has had the series of shots; if no immunity, evidence that provider has started the Hepatitis B vaccination series.) Varicella titer if provider has not had chicken pox and has direct patient contact. d. This is a non-personal health care service contract under which the Contractor is an independent Contractor. Contractor employees shall not be considered VA employees for any purpose. 10. HOUSEKEEPING REQIREMENTS: The contractor is responsible for all housekeeping requirements. Environment of Care Rounds shall be conducted and deficiencies shall be corrected by the Contractor prior to the next scheduled day of service. 11. MAINTENANCE REQUIREMENTS: a. Contractor shall be responsible for all maintenance of the unit including all Preventive Maintenances (PMs) as required by the manufacturer’s literature. The Contractor shall assume all cost for labor and parts including glassware and will make all arrangements for service upon notification of failure. Contractor shall communicate these occurrences and progress in a timely manner with Imaging Service staff and Healthcare Technology Management Staff. Anyone performing maintenance on the unit shall be factory trained by the manufacturer on this specific unit. Any FDA alerts or recalls associated with this equipment will be ameliorated in a timely manner. b. All PMs shall be done after normal operating hours, Monday – Friday. c. Contractor shall ensure a 98% or better up-time based upon the normal operation hours, Monday – Friday, 7:30 a.m. – 4:30 p.m. d. If the system breaks down, the MRI Technologist is responsible for informing Imaging Service representative and Healthcare Technology Management of the issue immediately upon determining there is a problem. The MRI Technologist will contact the vendor immediately if an on-site service technician is needed. It is expected that the on-site service technician will respond within 2 hours to determine what the problem is and a proposed timeframe of how long the machine is expected to be down. Repairs and delays that will be beyond two working days will require a replacement trailer to be brought in. 12. THE WEST TEXAS HEALTHCARE SYSTEM RESPONSIBILITIES: a. The West Texas VA Healthcare System shall provide a covered walkway (per VA design guidelines where applicable), utility connections, and an appropriate computer line(s) for use by the Contractor. The West Texas VA Healthcare System shall be responsible for scheduling exams for the mobile MRI unit. Providing Mobile MRI Pad: Mobile Pad (MRI criteria most stringent) Size: 55’ X 11’ 12” thick, no steel reinforcing under scanner section (may use carbon fiber, polyester, stainless steel) Assess for vibration (road, adjacent machinery) Assess for RF interference (adjacent electrical equipment, etc.) Connectivity: 480V 3 phase power, Russell Stoll connector Data , telephone, water 13. CONFORMANCE STANDARDS/REGULATORY ADHERENCE: a. Contractor shall perform the required services in accordance with the following: (1) the standards of the Joint Commission for the Accreditation of Healthcare Organizations (JC) to include Patient Safety Standards (a copy of these standards may be obtained from the Joint Commission on Accreditation of Healthcare Organizations, One Renaissance Blvd., Oakbrook Terrace, IL 60181) (2) the established principles and ethics of the medical profession established by the AMA and ACEP and is responsible for the quality of care rendered to all patients. (3) all relevant Federal and State regulations regarding patient care, medical practice, operation of MRI equipment; to include but not be limited to: Occupational Safety and Health Act (OSHA) The Joint Commission (JC) Veterans Health Administration (VHA) United States Department of Transportation (US DOT) Health Information Portability and Accountability Act (HIPAA) VHA Automated Information Security (AIS) Privacy Act THE VISN 17 FACILITY Medical Staff Bylaws b. Contractor shall ensure that the equipment/system functions in conformance with the latest published edition of OSHA and the manufacturer's specifications. c. Contractor shall adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). As required by HIPAA, the Department of Health and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs Veterans Health Administration (VA). 14. MRI STUDY INTERPRETATION: A VA-identified radiologist shall read/interpret all MRI studies and dictate all required study reports. MRI DATA OWNERSHIP: The West Texas Healthcare System shall maintain sole ownership of all data of studies performed on the mobile MRI under this contract. The Contractor may not use any portion of imaging data obtained from patient studies under the contract. The Contractor may not use any portion of imaging data obtained from patient studies for quality control or educational purposes without written consent of the West Texas Healthcare System. 15. EMERGENCIES ON MOBILE MRI UNIT: Emergency 911 shall handle all medical emergencies occurring on the mobile coach. The Contractor shall provide, with their proposal, a written emergency plan addressing emergencies such as patient codes, personal injury, fire, and disruptive behavior. 16. TELECOMMUNICATIONS: a. The mobile unit shall be equipped with an outlet connection capable of transmitting data and voice through a Government provided network interface jack (RJ11 Analog Voice and RJ45 IEEE 803.x). The Government shall provide the necessary network services required for the transmission of images, data and voice. The Contractor's mobile unit shall be able to connect to VISTA Imaging Network and to transmit all images to VISTA Imaging to include being compatible to DICOM imaging standards in use at the West Texas Healthcare System. (PACS interface contact person shall be provided to the Contractor during the post-award orientation). b. The Contractor shall be responsible for all expenses incurred to interface the MRI Scanner OEM using the DICOM network with the existing in use West Texas Healthcare System Picture Archiving and Communications System. The intent of this notice is to establish sources to define the procurement strategy (e.g., set- aside, sole source, unrestricted) for a solicitation that VA intends to post soon. Interested Contractors are requested to respond in accordance with the following: If you have an existing GSA or VA, Federal Supply Schedule contract, include the contract details in your response. Please note that VA is particularly interested in determining the availability of Small Business that can provide this service. Vendors are requested to submit estimated market research pricing with their responses. The estimated pricing will be considered when determining the procurement strategy for the future solicitation. (e.g., if the CO determines that capable small businesses cannot provide fair and reasonable pricing, then the solicitation will not be set-aside). Responses shall include: Business Name Business Address Point of Contact Name Phone Number E-mail Address SAM UID Number Currently registered in SAM (Yes or No). If Yes, provide expiration date. NAICS code Business Size: Small or Large Type of Business: Service-Disabled Veteran Owned (SDVOSB), Veteran Owned (VOSB), 8(a), HUBZone, Woman-Owned (WOSB), etc. GSA or VA FSS Contract Number, if applicable Current fleet size The contractor shall provide Emergent, non-emergent Advanced Life Support (ALS), and Critical Care Transport (CCT) Tier 1, 2, and 3 ambulance services on an as-needed basis in accordance with all federal, state, and local regulations. All businesses eligible to provide this service are encouraged to reply as this information may be used to determine potential set-asides for the above-noted requirement. Send responses to both the Contract Specialist and the Contracting Officer. Contracting Officer: Mr. Rafael Rodriguez at Rafael.Rodriguez2@va.gov