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HomeMy WebLinkAbout2006 CON SD Firefighters - Wellness ProgramAGREEMENT BETWEEN THE CITY OF NATIONAL CITY AND CITY OF SAN DIEGO FIREFIGHTERS REGIONAL WELLNESS PROGRAM FOR WELLNESS PROGRAM SERVICES THIS AGREEMENT is made, entered into, and effective as of the latest date set forth on the signature page hereto, by and between the City of National City on behalf of the National City Fire Department (NCFD), with its principal place of business located at 140 E. 12th Street Suite A, National City, CA 91950 and the City of San Diego Firefighters Regional Wellness Program (SDFFRWP), a municipal corporation, with its principal place of business located at 6699 Alvarado Road, Suite 101, San Diego, CA 92130. RECITALS WHEREAS, the NCFD applied for and received an Assistance to Firefighters Grant from the Federal Emergency Management Agency (FEMA), in part, to participate in the San Diego Firefighters Regional Wellness Program (SDFFRWP) which is in compliance with the International Association of Fire Fighters (IAFF) and the International Association of Fire Chiefs (IAFC) Health and Wellness Initiative guidelines; and WHEREAS, the NCFD has determined that the SDFFRWP has the expertise, experience, and personnel necessary to provide wellness program services required by the NCFD and described in the IAFF/IAFC Fire Service Joint Labor Management Wellness -Fitness Initiative (IAFF, 1999, ISBN# 0-942920-36-8) (http://www.iaff.oreisafetwellnessihtml). The program described in IAFF/IAFC Fire Service Joint Labor Management Wellness - Fitness Initiative (IAFF, 1999, ISBN# 0-942920-36-8) shall henceforth be described as the "Wellness Program" or "NCFD's Wellness Program"; and WHEREAS, the City of National City and SDFFRWP desire to enter into a contractual relationship which makes SDFFRWP the health provider agency of the NCFD's Wellness Program; NOW THEREFORE, in consideration of the mutual covenants and conditions set forth herein and for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereby agree as follows: Section 1. Compensation. 1.1 The City of National City and SDFFRWP agree to pay and bill respectively in accordance with the rates, fees and restrictions set forth in Item 1.1, 4.1, 4.3, and 4.4 of this agreement. NCFD Wellness Program 1 9/22/2006 1.2. SDFFRWP shall provide an invoice for services rendered during a calendar month to the NCFD by the 10th day of the next month. Services will be itemized, and presented in the following categories: 1.1.1. Clinical services 1.1.2. Consultation services 1.1.3. Lecture and workshop services Section 2. Term. 2.1. Term. The term of this Agreement shall be for a period of one (1) year from the effective date hereof. 2.2. Options to Renew. By mutual consent, this agreement may be renewed for three (3) one (1) year options, each for a period of one (1) year after the expiration of the original term, or the preceding one-year option term. Each option term shall be renewed on the same terms as this Agreement, except that the rates in section 4.1, 4.3, and 4.4 may be increased or decreased by mutual written agreement of the parties. Any rate changes shall he made at the time of exercise of the option, to take effect at the beginning of the new one year period unless otherwise agreed to in writing by the parties. 2.3. Exercise of Option to Renew. The City of National City shall give notice in writing of their intention to renew at least sixty (60) days prior to the expiration of the Agreement, or of the prior option term. If notice is provided by the NCFD to SDFFRWP, such notice shall be sent by mail addressed to: Wellness Officer San Diego Firefighters Regional Wellness Center 6699 Alvarado Road, Suite 101 San Diego. CA 92101 Section 3. NCFD Obligations. 3.1 Administration. The Chief of the NCFD or designated representative shall administer this Agreement on behalf of the NCFD and represent the NCFD in all matters pertaining to the Agreement. Section 4. Obligations. 4.1. Wellness Program Services. SDFFRWP agrees to provide services rendered at the location identified in Item 4.2 below, to NCFD employees participating in the Wellness Program (hereinafter "NCF) Employees"), at the fees for service identified in Item 4.3. SDFFRWP agrees to perform and/or coordinate all services identified in the Fire Service Joint Management Wellness - Fitness Initiative. The five components are Medical, Fitness, Injury Prevention NCFD Wellness Program 2 9/22/2006 and Rehabilitation, Behavioral Health and Data Collection. SDFFRWP agrees to provide the following services and/or collection of information: a. Prior to Medical Evaluation SDFFRWP agrees to provide all the necessary forms, reports, and documentation for the requested information listed below: Introductory letter describing the Firefighter Initiative Health history/Lifestyle questionnaire Health risk assessment Exercise risk assessment Participant information HIPAA information and acknowledgment Nutrition and diet analysis Arbitration agreement Explanation of testing procedures Instructions for participation Laboratory requisition (participant will have labs drawn at least one week prior to evaluation) Respiratory fit clearance form Request for immunization records Directions to facilities SDFFRWP will coordinate and provide staff to have blood drawn for lab analysis at designated fire stations at least one week prior to the participants' Wellness evaluation. The cost of this mobile service is included in the package price for the Medical Fitness Evaluations listed in section 4.3. b. Medical Evaluation Each participant will receive the following evaluations and follow up at the SDFFRWP Wellness Center: Vitals: height, weight, blood pressure, pulse, temperature and respirations Complete hands-on physical examination by a Physician or Physicians Assistant (PA). Blood profile including a CBC, chemistry panel and lipid panel. IIS CRP screening (cardiovascular risk factor) is optional and at an additional cost in accordance with the fee schedule. Chest x-ray Pulmonary Function Test, including lung volume and flow rate 12 lead EKG Lifestyle Questionnaire including 3-day diet analysis Hearing and Vision screening Cancer screening as appropriate at an additional cost, including PSA, pap smear, mammogram, CA-125. DOT/I)MV physical form NCFD Wellness Program 3 9/22/2006 c. Fitness Evaluation Maximal/Sub-Maximal (age determined) Exercise Test monitored by a 12 lead EKG Body Composition Abdominal Endurance Crunch Test Push-up Evaluation of Upper Body Strength and Endurance Grip Strength utilizing a hand dynamometer Leg Strength using the Jackson Strength Evaluation System Arm Strength using the Jackson Strength Evaluation System Flexibility evaluation utilizing the Novel Acuflex I or equivalent trunk flexibility tester In addition to the requested evaluations, assessment of low back muscular endurance at initial fitness evaluation using the Biering-Sorensen Test will be performed at no additional cost d. Schedule for Medical and Fitness Evaluations For each individual participating in the program: 45-60 minutes with Physician: physical exam, review labs and other test results 45-60 minutes with Exercise Physiologist: treadmill test 45 minutes with Athletic Trainer: strength, flexibility, body composition 45 minutes with Medical Assistant: vitals, vision, blood draw, hearing, pulmonary function, chest x-ray, review history and immunizations e. Follow-up Consultation with Physician at time of initial appointment. Follow-up on findings from annual examinations will be reviewed by the physician at time of evaluation. Abnormal findings on the annual physical will be addressed with specific recommendations to control or remedy the abnormality, and with recommendations for follow up or referral. Referrals will be made as appropriate for non -service connected issues, using the participants Primary Care Provider. Clearance will be given by the Physician following a recommended consult with an outside physician or after extended leave to determine return to work status. f. Personalized feedback from Exercise Physiologist and Athletic Trainer/Peer Fitness Trainer: Individual's level of fitness Level of improvement since past assessments Realistic evaluation of the individual's physical capacity to safely perform assigned jobs NCFD Wellness Program 4 9/22/2006 g• Suggested exercise program Comprehensive wellness/fitness program recommendations Firefighter Physical Performance Standard Score Physical Fitness Age Assessment Orthopedic/Musculoskeletal Rehabilitation if needed. Personalized written Health and Wellness Report Each firefighter will receive an individual packet two to four weeks following the medical and fitness evaluation that outlines his/her results. The Physician will review all parameters of the exam and provide a report detailing the findings of the medical and fitness exam. The report will outline recommendations for each individual to improve and maintain fitness, as well as recommend treatment or follow up for any medical condition. Educational material regarding various health topics will be included in the packet. h. Reporting and Recommendations SDFFRWP agrees to incorporate the current criteria used in Respiratory Fitness Clearance and Department of Motor Vehicles medical evaluations with regard to findings and risks. It is not the intention of the Wellness Program to re -define the existing fitness -for -duty criteria. Strict confidentiality and maintenance of records will be adhered to throughout any reporting and/or referral procedures. Healthy and fit: Participants will be given recommendations to maintain and improve fitness and health. Borderline result(s) demonstrating risk: Participant with borderline result(s) on any medical or fitness parameter will be given specific recommendations for follow up or intervention and there will be voluntary consultation with Peer Fitness Program. Significantly abnormal findings: Participant with abnormal findings will be given recommendations for follow up or intervention. This individual will receive consultation with Athletic Trainer and/or Exercise Physiologist and encouraged to enroll in Peer Fitness Program. Referral and specialized services will be offered through sub -contracted arrangements and/or the participant's personal physician. High risk with Abnormal results of medical or fitness evaluation placing firefighter, co-workers or public at risk: Physician will outline risks to participant. Participant will be taken off duty or given recommendation for alternative duty. Participant will receive individual counseling from Physician and appropriate referrals and recommendations will be made to reduce health risk. The same criteria used for Respiratory Fitness and NCFD Wellness Program 5 9/22/2006 DMV medical exams will be used for determination of being fit for duty. Participants must be cleared by Physician after completing appropriate recommendations prior to returning to full duty. Specialist Follow-up A team of Specialist Physicians has been organized to provide follow-up consultation as needed. The team includes Board Certified Physicians in Critical Care, Pulmonology, Infectious Diseases, Orthopaedics and Cardiology. All consultation and/or treatment services offered through these specialized programs will be at the request of the participant and approved by the Provider Physician, the Wellness Officer, and the NCFD. SDFFRWP agrees to make all contractual arrangements for these services and will invoice the NCFD on behalf of these contractors. These specialized services are not intended to replace the participant's personal physicians. Hazardous Materials Technician Physical Some of the firefighters in the NCFD may be designated as Hazardous Materials Technicians. Their special requirements for a physical will include the following: * All of the components and procedures of the Respiratory Fit Evaluation * Blood testing consisting of CBC, chemistry panel and heavy metals (arsenic, mercury and lead) and archiving of the results * Any additional blood testing required for specific or known exposure * EKG * Treadmill k. SCUBA Team Physical Some of the employees in the NCFD may he designated to perform duties underwater while wearing SCUBA gear. In anticipation of this, the SDFFRWP is prepared to be able to perform SCUBA physicals: * All of the components and procedures of the Respiratory Fit Evaluation * EKG * Chest x-ray * Blood testing consisting of CBC and chemistry panel * Additional services as required 1. Immunizations SDFFRWP agrees to offer NCFD employees on -duty influenza immunization and PPD (Tuberculosis) testing at strategic locations throughout the NCFD, as identified by the NCFD and agreed upon with the Wellness Officer, and charged according to the fee schedule. These NCFD Wellness Program 6 9/22/2006 services are mobilized and can accommodate 30 participants at one time. Each participant will complete a consent form describing risk and benefits of vaccines and PPD placement. Each participant will receive the immunization and/or PPD. A licensed individual will be present to administer or supervise administration of the immunization or PPD. The PPD will be read within 48 to 72 hours by a licensed individual. Scheduling will be determined by the NCFD and agreed upon with the Wellness Officer. m. Other Immunizations All immunization records and history of immunizations will be kept in patients chart. Review of immunizations will be made at the time of Wellness physical or respiratory fit exam. Necessary immunizations including Ilepatitis B will be given at that time and charged according to the fee schedule in 4.3. Additional immunizations as part of a series will be administered on an individual basis at the Wellness Center, scheduled by the Wellness Officer. 4.2. SDFFRWP Wellness Program Facilities. 4.2.1. Wellness Program Locations. SDFFRWP agrees to provide Wellness Program services to NCFD Employees at the following locations: WELLNESS CENTER (Main Location) (Co -located with Sun Diego Sports Medicine and Family Health Center) 6699 Alvarado Road, Suite 101 San Diego, CA 92120 Additionally, SDFFRWP in association with San Diego Sports Medicine and Family Health Center have offered access to all of the following locations for future expansion of the Wellness Program and utilization for the Peer Fitness Training program: San Diego Sports Medicine and Family Health Center 3880 Valley Center Drive, #210 San Diego, CA 92130 4.2.2. Early Disillusion or Termination of the Program. Upon termination of this Agreement between the City of National City and SDFFRWP, or termination of the Wellness Program, any and all pre- payments for services will be reimbursed to the City of National City. The City of National City shall provide at least sixty (60) days notice of intent to terminate this agreement. Provided however, that in the event the NCFD Wellness Program 7 9/22/2006 contract is terminated as a result of a material breach of contract on the part of SDFFRWP, then the City of National City will be entitled to reimbursement in full of any pro rata share of any pre -payment for services. 4.2.3. Staffing and Hours of Operation. SDFFRWP shall maintain a medical facility staffed by licensed physicians and technicians during business hours. In agreement with the City of National City, SDFFRWP shall commit to the days and hours of operation to comply with the goals of the Wellness Program, the Wellness Initiative and the FEMA grant. 4.2.4. Priority Appointments. SDFFRWP shall maintain a licensed physician available to examine and treat NCFD Employees that have arrived for their appointment. 4.2.5. Medical Specialists. SDFFRWP shall have "on call" medical specialists to examine patients either at the facilities listed above or at the specialist's office, for medical emergencies and follow-up care. 4.2.6. Medical Consultants. SDFFRWP shall maintain a list of medical specialty consultants for referral to NCFD Employees. 4.2.7. Other Medical Services. SDFFRWP shall provide radiological facilities on -site at the Wellness Center to facilitate comprehensive examinations. 4.2.8. Weekend and Evenings. The Wellness Center will not operate on weekends or evenings. 4.2.9. Cancelled/Delayed appointments. The NCFD is engaged in "All - Risk" emergency services, 24-hours a day. Due to unforeseen emergencies (fires, major incidents, disasters, etc.), it may be possible that an emergency crew and/or support personnel are otherwise engaged in emergency operations and unable to keep their appointment at the Wellness Center. All efforts will be made to provide personnel that are ready for their Wellness Center evaluation. It is NCFD's intent to present their employee(s) to the provider for services described herein during the days of operation. Pursuant to section 4.1 (d) the terms of this section may be changed after the first year based on the needs of NCFD. The days of operation and the number of personnel to receive the services will be determined based on an annual schedule and the need of NCFD and will be in consultation with the Wellness Officer. 4.2.10. Vacancy Fee. Despite the best efforts of the NCFD and/or appointed personnel assisting in scheduling Wellness activities, there may be occurrence that scheduled NCFD employees are NOT present for NCFD Wellness Program 8 9/22/2006 evaluation. The City of National City will pay a vacancy fee of $100 for any occurrence after two occurrences in any calendar month applicable only to days of operation. This section may be changed after the first year pursuant to section 4.1 (d) of this agreement. 4.3. Pricing of Services. The following prices have been established at the initiation of this agreement, and as referred in items 4.1, 4.5. and 4.7: CLINICAL SERVICES COST Medical Fitness Evaluation $1050.00 per participant Equipment maintenance fee $105.00 per participant Administrative fee $52.50 per participant Respiratory Fit Exam only $120.00 per participant Hazardous Materials Technician Physical (Additional fee for Wellness Participant) $370.00 per participant Hazardous Materials Technician Physical (Inclusive fee for NON -Participant) $490.00 per participant SCUBA Physical (Additional fee for Wellness Participant) $150.00 per participant _ SCUBA Physical (Inclusive fee for NON -Participant) $270.00 per participant Influenza Vaccinations * $10.00 per participant PPD testing * $18.00 per participant CONSULTATION SERVICES COST Physician Consultation Physical Therapy Consultation $300.00 per hour $100.00 per hour LECTURE & WORKSHOP SERVICES Back Workshop Nutritional and health related lectures COST $ 600.00 per lecture $200.00 per lecture to $500.00 per lecture * Fees for Influenza Vaccinations and PPD testing may be adjusted during the term of this agreement based on changes in current market price and availability of the vaccines. The adjusted fee will he determined by the average price of the vaccine or PPD through other local providers, plus 10% for administration. Authorization of the adjusted price and/or the decision to provide these services rests with the NCFD. NCFD Wellness Program 9 9/22/2006 4.3.1. Pre -Paid Fees for Services. Any pre -paid fees for service will be reimbursed back to the City of National City upon disillusion of this agreement. 4.4. Safety/Preventive Services. 4.4.1. SDFFRWP agrees to make available consulting/training in the area of safety/prevention services at the following rates: a. Physician time billed at $300 an hour. b. Non -physician time billed at $100 an hour. 4.5. Prescriptions. It is not the intention of this Agreement or the City of National City that medications shall be dispensed during the scope of the Wellness Program. If the consulting physician identifies a need to prescribe a medication, he/she can provide a prescription at no additional cost, or make a referral to the employee's own physician. The City of National City shall not reimburse either the employee or SDFFRWP for prescription or non-prescription medications. 4.6. Vision and Audiometric Examinations.. SDFFRWP agrees to provide vision and audiometric examinations to NCFD Employees as referenced by guidelines published by the California Department of Motor Vehicles (DMV). 4.7. Respiratory Examinations. SDFFRWP agrees to provide respiratory examinations to NCFD Employees as referenced by guidelines published by the Occupational Safety and Health Administration (OSHA). 4.8. Performance Standards. It is the intent of SDFFRWP and the City of National City to provide quality medical care and other Wellness services for NCFD Employees. To maintain and improve the quality, access, availability, and cost-effectiveness of the services provided under this Agreement, SDFFRWP and the City of National City each agree to use their best efforts to develop means and standards for measuring the performance of SDFFRWP under the Agreement, including, but not limited to the following: 4.8.1. Measurement of Key Performance Indicators, including time lost from injury, vital signs, body mass index (BMI), cholesterol levels, and subjective surveys of participant's satisfaction. 4.8.2. Comparison of these indicators with other fire departments as available through the International Association of Fire Fighters (IAFF) Wellness Initiative database. 4.8.3. Comparison of these indicators with other fire departments as available through the San Diego County Fire Chiefs Association (to be determined). NCFD Wellness Program 10 9/22/2006 4.8.4. Other factors to be established by SDFFRWP and the City of National City. 4.8.5. SDFFRWP shall establish a complaint review process to identify and monitor complaints made by NCFD Employees, and review and discuss complaints with the NCFD based on confidentiality and other legal constraints. 4.8.6. SDFFRWP agrees to conduct or cause to be conducted a patient satisfaction survey. SDFFRWP shall continue to consult with the City of National City regarding the substance, procedure and results of each survey. 4.8.7. In addition to the requirements of California law for licensing of professional medical staff, SDFFRWP shall, at Least every two years, review the credentials and qualifications of its medical staff, pursuant to procedures established by SDFFRWP. The Credential Review shall include review of patient complaints, satisfaction surveys, site visits, results of quality reviews, utilization management, and peer reviews. 4.9. City of National City's Reservation of Rights. The City of National City reserves the right to review and approve all logos, promotional materials, promotional campaigns, and any and all other materials that represent SDFFRWP's efforts to publicize and/or promote the Wellness Program on behalf of the NCFD. 4.10. SDFFRWP Representative. SDFFRWP shall designate that the Wellness Officer of SDFFRWP will represent SDFFRWP in all matters pertaining to this Agreement. Section 5. Administrative Services 5.1. Periodic Meetings. Subject to any state and federal privacy laws, SDFFRWP agrees to meet with the NCFD's staff as scheduled to confidentially discuss program issues, utilization of medical specialties, utilization of physical therapy, trends and any topic of interest pertaining to the Wellness Program and SDFFRWP. 5.2. Work -Related Injuries: Initial Medical Reporting. While it is not the intent of the Wellness Program to diagnose or otherwise treat any suspected work - related injuries, in the course of a Wellness/Fitness evaluation a suspected work - related injury or illness may be discovered. SDFFRWP shall refer all NCFD employees, with a suspected work -related injury or illness, to the NCFD for coordination of medical care, unless a life threatening medical emergency exists that requires medical treatment. SDFFRWP will direct the employee to follow all NCFD Wellness Program l l 9/22/2006 NCFD procedures for reporting a work related injury or illness. Following any emergency medical treatment, SDFFRWP shall report the treatment to the NCFD for the purposes of follow-up medical treatment. In the case of emergency medical treatment, SDFFRWP shall provide the NCFD with a Doctors First Report of Work Injury or Illness (form 5020) within two days of initial treatment and all billing. SDFFRWP is not authorized to determine causation of any suspected work related injury or illness. 5.3. Work -Related Injuries: Medical Reports and Billings. SDFFRWP shall use those reports, billings and associated forms in a format approved by the NCFD for any and all work related injuries reported. 5.4. Maintenance of Medical Reports. SDFFRWP shall accurately maintain, store and retrieve employee medical files during the period of this Agreement in accordance with all applicable laws and regulations. 5.5. Confidentiality. SDFFRWP shall ensure security of the medical records for all Wellness Program participants and shall ensure compliance with all State and Federal Privacy Laws. At no time shall SDFFRWP or San Diego Sports Medicine release confidential medical records to the City of National City without written authorization from the employee. 5.6. Testimony. SDFFRWP shall, upon reasonable notice, submit to depositions and testify at court if requested by the City of National City. 5.7. Return -to -Work Consulting. SDFFRWP shall provide consulting services by working with NCFD staff on returning injured NCFD employees, when appropriate, to modified duty. 5.8. Special Treatment Consulting. SDFFRWP shall provide recommendations to Wellness Participants regarding surgical options, special medical treatments, or other special medical procedures identified during the Wellness exam as requiring such treatment or services. 5.9. Authorization for Patient Referral. SDFFRWP shall insure that the employee is instructed that any referral made to a specialist or hospital will NOT be reimbursed by the Wellness Program unless authorized by both the Medical Director and the Wellness Officer. Section 6. Indemnification and Hold Harmless. 6.1. The City of San Diego (City) agrees to defend, indemnify, protect and hold the City of National City and its agents, officers and employees harmless from and against any and all claims asserted or liability established for damages or injuries to any person or property, including injury to NCFD's employees, agents NCFD Wellness Program 12 9/22/2006 or officers, which arise from or are connected with or are caused or claimed to be caused by the acts or omissions of City and SDFFRWP and its employees in performing the work or services or supplying the materials or equipment under this Agreement, and all expenses, of investigating and defending against same; provided, however, that City's duty to defend, indemnify and hold harmless shall not include any claims or liability arising from the sole negligence or sole willful misconduct of the City of National City, its agents, officers or employees. This shall not prejudice the right of the City of National City to appear in such suit, participate in the defense, and take such actions as may be necessary to protect the interests of the City of National City. If the City of National City chooses, at its own election, to obtain independent legal counsel in defense of any claim against the City of National City, related to the performance of City and SDFFRWP under this Agreement, then City agrees to pay the reasonable value of attorney's fees and costs for such independent legal counsel, however, City shall not be obligated to pay attorney's fees at an hourly rate greater than the hourly rate charged by its defense attorneys in the same matter. City's obligations under this section shall be reduced dollar for dollar by any amounts the City of National City is awarded in such action for attorney's fees and costs. 6.2. The City of National City agrees to defend, indemnify, protect and hold City and it's employees harmless from and against any and all claims asserted or liability established for damages or injuries to any person or property, including injury to City employees, agents or officers, which arise from or are connected with or are caused or claimed to he caused by the sole negligence or sole willful misconduct of the City of National City and its officers or employees in performing the work or services or supplying the materials or equipment under this Agreement, and all expenses, of investigating and defending against same; provided, however, that the City of National City's duty to defend, indemnify and hold harmless shall not include any claims or liability arising from the sole negligence or sole willful misconduct of City or SDFFRWP, or its employees. This shall not prejudice the right of City to appear in such suit, participate in the defense, and take such actions as may be necessary to protect the interests of City. If City chooses, at its own election, to obtain independent legal counsel in defense of any claim against the City of National City, related to the performance of the City of National City under this Agreement, then the City of National City agrees to pay the reasonable value of attomey's fees and costs for such independent legal counsel, however, the City of National City shall not he obligated to pay attorney's fees at an hourly rate greater than the hourly rate charged by its defense attorneys in the same matter. The City of National City's obligations under this section shall be reduced dollar for dollar by any amounts City or SDFFRWP is awarded in such action for attorney's fees and costs Section 7. Termination. Unless terminated sooner in accordance with its terms, this Agreement shall terminate as set forth in Item 2. This Agreement may be terminated for any reason by NCFD Wellness Program 13 9/22/2006 either party giving sixty (60) days written notice to the other parry's designated representative, provided that the Indenmification and Duty to Defend provisions in Item 6 shall survive such termination, for a period ()lone year. Notice under this provision shall be communicated in writing in person or by certified mail, return receipt requested as follows: If to SDFFRWP: If to the City of National City: Wellness Officer 6699 Alvarado Road, Suite 101 San Diego, CA 92120 Fire Chief National City Fire Department 140 F. 12th Street Suite A National City, CA 91950 Notice will be deemed to be provided upon the earlier of actual receipt (or refusal to accept receipt) or the fifth business day after deposit in the mail as required in this Agreement. Section 8. Lack of Sufficient Funds. This Agreement shall be terminated immediately if the City of National City does not annually appropriate sufficient funds to the Wellness Program. Section 9. Equal Opportunity. SDFFRWP shall comply with the City of National City's Equal Opportunity Program. Section 10. Drug -Free Workplace. Upon execution of this Agreement and all subsequent extensions, SDFFRWP agrees to comply with any requirements set forth in City of National City policy regarding drug -free workplace. Section 11. Americans with Disabilities Act Statement. SDFFRWP shall be responsible for complying with the 1990 Americans with Disabilities Act (ADA). (For specific services and public accommodations, SDFFRWP may contact the Office of the Americans with Disabilities Act, Civil Rights Division, U.S. Department of Justice, P.O. Box 66118, Washington, D.C. 20035-6118; phone number (202) 514-0301.) Section 12. Confidentiality and Internal Use NCFD Wellness Program 14 9/22/2006 12.1. City of National City and SDFFRWP agree that all services and work product under this Agreement shall be solely for the informational purposes and internal use of both parties. Parties further agree that such information, services and work product shall not be used by, or circulated, quoted, disclosed, or distributed to, nor shall reference to such services or work product be made to, any person or entity other than the City of National City and SDFFRWP and its staffs except (a) as may he required by law, regulation, judicial or administrative process, or in accordance with applicable professional standards, or in connection with litigation pertaining hereto or (b) to the extent such information shall have otherwise become publicly available. 12.2. To the extent that, in connection with this Agreement, SDFFRWP comes into possession of any proprietary or confidential information of the City of National City, SDFFRWP shall not disclose such information to any third party without the City of National City's consent, except (a) as may be required by law, regulation, judicial or administrative process, or in accordance with applicable professional standards, or in connection with litigation pertaining thereto, or (b) to the extent such information shall have otherwise become publicly available (including, without limitation, any information filed with any governmental agency and available to the public) other than as the result of a disclosure by SDFFRWP in breach hereof, (c ) becomes available to SDFFRWP on a non -confidential basis from a source other than the City of National City which SDFFRWP does not believe is prohibited from disclosing such information to SDFFRWP by obligation to the City of National City, (d) is known by SDFFRWP prior to its receipt from the City of National City without any obligation of confidentiality with respect thereto, or (e) is developed by SDFFRWP independently of any disclosures made by the City of National City to SDFFRWP of such information. Section 14. Integration. This Agreement, and all rights and obligations created by this Agreement, shall be in full force and effect whether or not any parties to the Agreement have been succeeded by another entity, and all rights and obligations created by this Agreement shall be vested and binding on any parry's successor in interest. Section 15. Non -Assignment. SDFFRWP shall not assign the obligations under this Agreement, whether by express assignment or by sale of the company, nor any monies due or to become due, without the City of National City's prior written approval, which approval shall not be held unreasonably. Any assignment in violation of this paragraph shall constitute a Default and is grounds for immediate termination of this Agreement, at the sole NCFD Wellness Program 15 9/22/2006 discretion of the City of National City. In no event shall any putative assignment create a contractual relationship between the City of National City and any putative assignee. Section 16. Compliance with Controlling Law. SDFFRWP shall comply with all laws, ordinance, regulations, and policies of the federal, state, and local governments applicable to this Agreement. In addition, SDFFRWP shall comply within a reasonable time after receiving written notice by NCFD with all directives issued by the NCFD or its authorized representatives under authority of any laws, statutes, ordinance, rules, or regulations. The laws of the State of California shall govern and control the terms and conditions of this Agreement. Section 17. Jurisdiction and Venue. The venue for any suit or proceeding concerning the Agreement, the interpretation or application of any of its terms, or any related disputes shall be in the County of San Diego, State of California. Section 18. No Waiver. No failure of either the City of National City or SDFFRWP to insist upon the strict performance by the other of any covenant, term or condition of the Agreement, nor any failure to exercise any right or remedy consequent upon a breach of any covenant, term, or condition of the Agreement, shall constitute a waiver of any such breach or of such covenant, term or condition. No waiver of any breach shall affect or alter this Agreement, and each and every covenant, condition, and term hereof shall continue in full force and effect to any existing or subsequent breach. Section 19. Severability. The unenforceability, invalidity, or illegality of any provision of this Agreement shall not render any other provision of this Agreement unenforceable, invalid, or illegal. Section 20. Drafting Ambiguities. The Parties agree that they are aware they have the right to he advised by counsel with respect to the negotiations, terms and conditions of this Agreement, and the decision whether or not to seek advice of counsel with respect to this Agreement is a decision which is the sole responsibility of each Party. This Agreement shall not be construed in favor of or against either Party by reason of the extent to which each Party participated in the drafting of this Agreement. NCFD Wellness Program 16 9/22/2006 Section 21 . Signatures —Counterparts. 'This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. This Agreement shall not be effective until the execution and delivery between each of the parties of at least one set of counterparts. The parties authorize each other to detach and combine original signature pages and consolidate them into a single identical original. Any one of such completely executed counterparts shall be sufficient proof of this Agreement. IN WITNESS WHEREOF, this Agreement is executed by the City of National City, acting by and through its Mayor and by SDFFRWP, acting by and through its Wellness Officer. CITY OF NATIONAL CITY Dated: 1/8/07 By Ron Morrison Mayor CITY OF SAN DIEGO FIREFIGHTFS REGIONAL WELLNESS PROGRAM. Dated: (4. --` / O By ` 'I'{acy Jarman Fire Chief CITY OF SAN DIEGO Dated: / 2 3/) b By Rick Reynolds Assistant Chief Operating Officer 1 HEREBY APPROVE the form and legality of this agreement between the City of San Diego Firefighters Regional Wellness Program and National City Fire Department for Wellness Program Services. MICHAEL J. AGUIRRE, CITY ATTORNEY Dated: By Nooria F Deputy City Attorri NCFD Wellness Program 17 9/22/2006 RESOLUTION NO. 2006 — 231 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY AUTHORIZING THE MAYOR TO EXECUTE AN AGREEMENT BETWEEN THE CITY OF NATIONAL CITY AND SAN DIEGO FIREFIGHTERS REGIONAL WELLNESS PROGRAM FOR WELLNESS PROGRAM SERVICES WHEREAS, the City of National City's Fire Department seeks to enhance its existing wellness -fitness program; and WHEREAS, .the City of National City's Fire Department applied and received approval for grant funds from the Federal Department of Homeland Security; and WHEREAS, the Federal Department of Homeland Security awarded $46,012 or 80% in grant funding to the City of National City to be used to join the San Diego Firefighters Regional Wellness Program; and WHEREAS, the City of National City is required to allocate $11,502 or a 20% match to receive the grant funding; and WHEREAS, the City of National City's Fire Department determined that the San Diego Firefighters Regional Wellness Program has the expertise, experience, and personnel necessary to provide wellness program services required by the City of National City's Fire Department; and WHEREAS, the City of National City and San Diego Firefighters Regional Wellness Program desire to enter into a contractual relationship which makes San Diego Firefighters Regional Wellness Program the health provider agency of the City of National City's Fire Department's Wellness Program. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby authorizes the Mayor to execute the Agreement between the City of National City and San Diego Firefighters Regional Wellness Program for wellness program services. Said agreement is on file in the office of the City Clerk. PASSED and ADOPTED this 21s' day of November, 2006. Nic n n •a, or ATTEST: Mich el R. Dalla, C ty Clerk APPROVED AS TO FORM: George H. Eiser, III City Attorney Passed and adopted by the Council of the City of National City, California, on November 21, 2006, by the following vote, to -wit: Ayes: Councilmembers Inzunza, Morrison, Natividad , Parra. Nays: None. Absent: Zarate . Abstain: None. AUTHENTICATED BY: NICK INZUNZA Mayor of the City of National City, California '41‘jd City lerk of the City f National City, California By: Deputy I HEREBY CERTIFY that the above and foregoing is a full, true and correct copy of RESOLUTION NO. 2006-231 of the City of National City, California, passed and adopted by the Council of said City on November 21, 2006. City Clerk of the City of National City, California By: Deputy City of National City, California COUNCIL AGENDA STATEMENT MEETING DATE 11/21/06 AGENDA ITEM NO. 10 ITEM TITLE RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY AUTHORIZING THE MAYOR TO EXECUTE THE AGREEMENT BETWEEN THE NATIONAL CITY FIRE DEPARTMENT AND CITY OF SAN DIEGO FIREFIGHTERS REGIONAL WELLNESS PROGRAM FOR WELLNESS PROGRAM SERVICES. n PREPARED BY Walter Amedee *)• r DEPARTMENT Fire Homeland Security Manager EXPLANATION The federal Department of Homeland Security has announced the City of National City would be awarded $46,012 or 80"/o in new funding for the National City Fire Department (NCFD) to join the San Diego Firefighters Regional Wellness Program (SDFFRWP) valued at $57,514. The City is required to allocate $11,502 or a 20% match to receive the funding. By joining the SDFFRWP, the NCFD Firefighters will provide detailed annual medical/fitness evaluations and related follow-up (i.e., customized fitness and injury prevention programs) for our firefighters. The SDFFRWP will allow our firefighters to become more physically able to safely carry out their work responsibilities, which in turn, will help reduce work -related injuries and costs, and make our community a safer place to live. We anticipate that the efficacy of the program, in terms of cost -savings and health benefits, will be documented in subsequent years. Staff recommends authorizing the Mayor to execute the agreement between the NCFD and the SDFFRWP for wellness program services. The FY05 Assistance to Firefighters Grant Program was a competitive grant that required agencies to complete an on-line application and narrative justifying the use of funds. Environmental Review N/A Financial Statement Approved By: Finance Director Minor impact; FY05 Assistance to Firefighters Grant Program is a grant that requires the City to allocate $11,502 or 20% match to receive $46,012 or 80% in grant funds. The majority of the $11,502 will come from existing NCFD Medical Supplies/Services Accounts. Account No. STAFF RECOMMENDATION Staff recommends authorizing the Mayor to execute the agreement between the NCFD and the SDFFRWP for wellness program services. BOARD / COMMISSION RECOMMENDATION ATTACHMENTS ( Listed Below) Resolution No. a,OD, - . 3 j 1. Agreement 2. Resolution A-200 (9/99) AGREEMENT BETWEEN THE CITY OF NATIONAL CITY AND CITY OF SAN DIEGO FIREFIGHTERS REGIONAL WELLNESS PROGRAM FOR WELLNESS PROGRAM SERVICES THIS AGREEMENT is made, entered into, and effective as of the latest date set forth on the signature page hereto, by and between the City of National City on behalf of the National City Fire Department (NCFD), with its principal place of business located at 140 E. 12' Street Suite A, National City, CA 91950 and the City of San Diego Firefighters Regional Wellness Program (SDI~IRWP), a municipal corporation, with its principal place of business located at 6699 Alvarado Road, Suite 101, San Diego, CA 92130. RECITALS WHEREAS, the NCFD applied for and received an Assistance to Firefighters Grant from the Federal Emergency Management Agency (FEMA), in part, to participate in the San Diego Firefighters Regional Wellness Program (SDFFRWP) which is in compliance with the International Association of Fire Fighters (IAFF) and the International Association of Fire Chiefs (IAFC) Health and Wellness Initiative guidelines; and WHEREAS, the NCFD has determined that the SDFFRWP has the expertise, experience, and personnel necessary to provide wellness program services required by the NCFD and described in the IAFF/IAFC Fire Service Joint Labor Management Wellness -Fitness Initiative (IAFF, 1999, ISBN# 0-942920-36-8) (http://www.iaff.org/safe/wellness2.html). The program described in IAFF/IAFC Fire Service Joint Labor Management Wellncss- Fitness Initiative (IAFF, 1999, ISBN# 0-942920-36-8) shall henceforth be described as the "Wellness Program" or "NCFD's Wellness Program"; and WHEREAS, the City of National City and SDFFRWP desire to enter into a contractual relationship which makes SDFFRWP the health provider agency of the NCFD's Wellness Program; NOW THEREFORE, in consideration of the mutual covenants and conditions set forth herein and for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties hereby agree as follows: Section 1. Compensation. NCFD Wellness Program 1 9/22/2006 1.1 The City of National City and SDFFRWP agree to pay and bill respectively in accordance with the rates, fees and restrictions set forth in Item 1.1, 4.1, 4.3, and 4.4 of this agreement. 1.2. SDFFRWP shall provide an invoice for services rendered during a calendar month to the NCFD by the 10th day of the next month. Services will be itemized, and presented in the following categories: 1.1.1. Clinical services 1.1.2. Consultation services 1.1.3. Lecture and workshop services Section 2. Term. 2.1. Term. The term of this Agreement shall be for a period of one (1) year from the effective date hereof. 2.2. Options to Renew. By mutual consent, this agreement may be renewed for three (3) one (1) year options, each for a period of one (1) year after the expiration of the original term, or the preceding one-year option term. Each option term shall be renewed on the same terms as this Agreement, except that the rates in section 4.1, 4.3, and 4.4 may be increased or decreased by mutual written agreement of the parties. Any rate changes shall be made at the time of exercise of the option, to take effect at the beginning of the new one year period unless otherwise agreed to in writing by the parties. 2.3. Exercise of Option to Renew. The City of National City shall give notice in writing of their intention to renew at least sixty (60) days prior to the expiration of the Agreement, or of the prior option term. If notice is provided by the NCFD to SDFFRWP, such notice shall be sent by mail addressed to: Wellness Officer San Diego Firefighters Regional Wellness Center 6699 Alvarado Road, Suite 101 San Diego, CA 92101 Section 3. NCFD Obligations. 3.1 Administration. The Chief of the NCFD or designated representative shall administer this Agreement on behalf of the NCFD and represent the NCFD in all matters pertaining to the Agreement. Section 4. Obligations. NCFD Wellness Program 2 9/22/2006 4.1. Wellness Program Services. SDFFRWP agrees to provide services rendered at the location identified in Item 4.2 below, to NCFD employees participating in the Wellness Program (hereinafter "NCFD Employees"), at the fees for service identified in Item 4.3. SDFFRWP agrees to perform and/or coordinate all services identified in the Fire Service Joint Management Wcllness- Fitness Initiative. The five components are Medical, Fitness, Injury Prevention and Rehabilitation, Behavioral Health and Data Collection. SDI1-RWP agrees to provide the following services and/or collection of information: a. Prior to Medical Evaluation SDFFRWP agrees to provide all the necessary forms, reports, and documentation for the requested information listed below: Introductory letter describing the Firefighter Initiative Health history/Lifestyle questionnaire Health risk assessment Exercise risk assessment Participant information HIPAA information and acknowledgment Nutrition and diet analysis Arbitration agreement Explanation of testing procedures Instructions for participation Laboratory requisition (participant will have labs drawn at least one week prior to evaluation) Respiratory fit clearance form Request for immunization records Directions to facilities SDFFRWP will coordinate and provide staff to have blood drawn for lab analysis at designated fire stations at least one week prior to the participants' Wellness evaluation. The cost of this mobile service is included in the package price for the Medical Fitness Evaluations listed in section 4.3. b. Medical Evaluation Each participant will receive the following evaluations and follow up at the SDFFRWP Wellness Center: Vitals: height, weight, blood pressure, pulse, temperature and respirations Complete hands-on physical examination by a Physician or Physicians Assistant (PA). Blood profile including a CBC, chemistry panel and lipid panel. HS CRP screening (cardiovascular risk factor) is optional and at an additional cost in accordance with the fee schedule. Chest x-ray Pulmonary Function Test, including lung volume and flow rate NCFD Wellness Program 3 9/22/2006 12 lead EKG Lifestyle Questionnaire including 3-day diet analysis Hearing and Vision screening Cancer screening as appropriate at an additional cost, including PSA, pap smear, mammogram, CA-125. DOT/DMV physical form c. Fitness Evaluation Maximal/Sub-Maximal (age determined) Exercise Test monitored by a 12 lead EKG Body Composition Abdominal Endurance Crunch Test Push-up Evaluation of Upper Body Strength and Endurance Grip Strength utilizing a hand dynamometer Leg Strength using the Jackson Strength Evaluation System Arm Strength using the Jackson Strength Evaluation System Flexibility evaluation utilizing the Novel Acuflex I or equivalent trunk flexibility tester In addition to the requested evaluations, assessment of low back muscular endurance at initial fitness evaluation using the Biering-Sorensen Test will be performed at no additional cost d. Schedule for Medical and Fitness Evaluations For each individual participating in the program: 45-60 minutes with Physician: physical exam, review labs and other test results 45-60 minutes with Exercise Physiologist: treadmill test 45 minutes with Athletic Trainer: strength, flexibility, body composition 45 minutes with Medical Assistant: vitals, vision, blood draw, hearing, pulmonary function, chest x-ray, review history and immunizations e. Follow-up Consultation with Physician at time of initial appointment. Follow-up on findings from annual examinations will be reviewed by the physician at time of evaluation. Abnormal findings on the annual physical will be addressed with specific recommendations to control or remedy the abnormality, and with recommendations for follow up or referral. Referrals will he made as appropriate for non -service connected issues, using the participants Primary Care Provider. Clearance will be given by the Physician following a recommended consult with an outside physician or after extended leave to determine return to work status. NCFD Wellness Program 4 9/22/2006 f. Personalized feedback from Exercise Physiologist and Athletic Trainer/Peer Fitness Trainer: g• Individual's level of fitness Level of improvement since past assessments Realistic evaluation of the individual's physical capacity to safely perform assigned jobs Suggested exercise program Comprehensive wellness/fitness program recommendations Firefighter Physical Performance Standard Score Physical Fitness Age Assessment Orthopedic/Musculoskeletal Rehabilitation if needed. Personalized written Health and Wellness Report Each firefighter will receive an individual packet two to four weeks following the medical and fitness evaluation that outlines his/her results. The Physician will review all parameters of the exam and provide a report detailing the findings of the medical and fitness exam. The report will outline recommendations for each individual to improve and maintain fitness, as well as recommend treatment or follow up for any medical condition. Educational material regarding various health topics will he included in the packet. h. Reporting and Recommendations SDI RWP agrees to incorporate the current criteria used in Respiratory Fitness Clearance and Department of Motor Vehicles medical evaluations with regard to findings and risks. It is not the intention of the Wellness Program to re -define the existing fitness -for -duty criteria. Strict confidentiality and maintenance of records will be adhered to throughout any reporting and/or referral procedures. Healthy and fit: Participants will be given recommendations to maintain and improve fitness and health. Borderline result(s) demonstrating risk: Participant with borderline result(s) on any medical or fitness parameter will be given specific recommendations for follow up or intervention and there will be voluntary consultation with Peer Fitness Program. Significantly abnormal findings: Participant with abnormal findings will be given recommendations for follow up or intervention. This individual will receive consultation with Athletic Trainer and/or Exercise Physiologist and encouraged to enroll in Peer Fitness Program. Referral and specialized services will be offered through sub -contracted arrangements and/or the participant's personal physician. NCFD Wellness Program 5 9/22/2006 High risk with Abnormal results of medical or fitness evaluation placing firefighter, co-workers or public at risk: Physician will outline risks to participant. Participant will be taken off duty or given recommendation for alternative duty. Participant will receive individual counseling from Physician and appropriate referrals and recommendations will be made to reduce health risk. The same criteria used for Respiratory Fitness and DMV medical exams will be used for determination of being fit for duty. Participants must be cleared by Physician after completing appropriate recommendations prior to returning to full duty. Specialist Follow-up A team of Specialist Physicians has been organized to provide follow-up consultation as needed. The team includes Board Certified Physicians in Critical Care, Pulmonology, Infectious Diseases, Orthopaedics and Cardiology. All consultation and/or treatment services offered through these specialized programs will be at the request of the participant and approved by the Provider Physician, the Wellness Officer, and the NCFD. SDFFRWP agrees to make all contractual arrangements for these services and will invoice the NCFD on behalf of these contractors. These specialized services are not intended to replace the participant's personal physicians. Hazardous Materials Technician Physical Some of the firefighters in the NCFD may be designated as Hazardous Materials Technicians. Their special requirements for a physical will include the following: * All of the components and procedures of the Respiratory Fit Evaluation * Blood testing consisting of CBC, chemistry panel and heavy metals (arsenic, mercury and lead) and archiving of the results * Any additional blood testing required for specific or known exposure * EKG * Treadmill k. SCUBA Team Physical Some of the employees in the NCFD may be designated to perform duties underwater while wearing SCUBA gear. In anticipation of this, the SDFFRWP is prepared to be able to perform SCUBA physicals: * All of the components and procedures of the Respiratory Fit Evaluation * EKG * Chest x-ray * Blood testing consisting of CBC and chemistry panel * Additional services as required NCFD Wellness Program 6 9/22/2006 1. Immunizations SDFFRWP agrees to offer NCFD employees on -duty influenza immunization and PPD (Tuberculosis) testing at strategic locations throughout the NCFD, as identified by the NCFD and agreed upon with the Wellness Officer, and charged according to the fee schedule. These services are mobilized and can accommodate 30 participants at one time. Each participant will complete a consent form describing risk and benefits of vaccines and PPD placement. Each participant will receive the immunization and/or PPD. A licensed individual will he present to administer or supervise administration of the immunization or PPD. The PPD will be read within 48 to 72 hours by a licensed individual. Scheduling will be determined by the NCFD and agreed upon with the Wellness Officer. m. Other Immunizations All immunization records and history of immunizations will be kept in patients chart. Review of inununizations will be made at the time of Wellness physical or respiratory fit exam. Necessary immunizations including Hepatitis B will be given at that time and charged according to the fee schedule in 4.3. Additional immunizations as part of a series will be administered on an individual basis at the Wellness Center, scheduled by the Wellness Officer. 4.2. SDFFRWP Wellness Program Facilities. 4.2.1. Wellness Program Locations. SDFFRWP agrees to provide Wellness Program services to NCFD Employees at the following locations: WELLNESS CENTER (Main Location) (Co -located with San Diego Sports Medicine and Family Health Center) 6699 Alvarado Road, Suite 101 San Diego, CA 92120 Additionally, SDFFRWP in association with San Diego Sports Medicine and Family Health Center have offered access to all of the following locations for future expansion of the Wellness Program and utilization for the Peer Fitness Training program: San Diego Sports Medicine and Family Health Center 3880 Valley Center Drive, #210 San Diego, CA 92130 NCFD Wellness Program 7 9/22/2006 4.2.2. Early Disillusion or Termination of the Program. Upon termination of this Agreement between the City of National City and SD1-FRWP, or termination of the Wellness Program, any and all pre- payments for services will be reimbursed to the City of National City. The City of National City shall provide at least sixty (60) days notice of intent to terminate this agreement. Provided however, that in the event the contract is terminated as a result of a material breach of contract on the part of SDFFRWP, then the City of National City will be entitled to reimbursement in full of any pro rata share of any pre -payment for services. 4.2.3. Staffing and Hours of Operation. SDFFRWP shall maintain a medical facility staffed by licensed physicians and technicians during business hours. In agreement with the City of National City, SDFFRWP shall commit to the days and hours of operation to comply with the goals of the Wellness Program, the Wellness Initiative and the FEMA grant. 4.2.4. Priority Appointments. SDFFRWP shall maintain a licensed physician available to examine and treat NCFD Employees that have arrived for their appointment. 4.2.5. Medical Specialists. SDFFRWP shall have "on call" medical specialists to examine patients either at the facilities listed above or at the specialist's office, for medical emergencies and follow-up care. 4.2.6. Medical Consultants. SDFFRWP shall maintain a list of medical specialty consultants for referral to NCFD Employees. 4.2.7. Other Medical Services. SDFFRWP shall provide radiological facilities on -site at the Wellness Censer to facilitate comprehensive examinations. 4.2.8. Weekend and Evenings. The Wellness Center will not operate on weekends or evenings. 4.2.9. Cancelled/Delayed appointments. The NCFD is engaged in "All - Risk" emergency services, 24-hours a day. Due to unforeseen emergencies (fires, major incidents, disasters, etc.), it may be possible that an emergency crew and/or support personnel are otherwise engaged in emergency operations and unable to keep their appointment at the Wellness Center. All efforts will be made to provide personnel that are ready for their Wellness Center evaluation. It is NCFD's intent to present their employee(s) to the provider for services described herein during the days of operation. Pursuant to section 4.1 (d) the terms of this section may be changed after the first year based on the needs of NCFD. The days of NCFD Wellness Program R 9/22/2006 operation and the number of personnel to receive the services will be determined based on an annual schedule and the need of NCFD and will be in consultation with the Wellness Officer. 4.2.10. Vacancy Fee. Despite the best efforts of the NCFD and/or appointed personnel assisting in scheduling Wellness activities, there may be occurrence that scheduled NCFD employees are NOT present for evaluation. The City of National City will pay a vacancy fee of $100 for any occurrence after two occurrences in any calendar month applicable only to days of operation. This section may be changed after the first year pursuant to section 4.1 (d) of this agreement. 4.3. Pricing of Services. The following prices have been established at the initiation of this agreement, and as referred in items 4.1, 4.5, and 4.7: CLINICAL SERVICES COST Medical Fitness Evaluation $1050.00 per participant Equipment maintenance fee $105.00 per participant Administrative fee $52.50 per participant Respiratory Fit Exam only $120.00 per participant Hazardous Materials Technician Physical (Additional fee for Wellness Participant) $370.00 per participant Hazardous Materials Technician Physical (Inclusive fee for NON -Participant) $490.00 per participant SCUBA Physical (Additional fee for Wellness Participant) $150.00 per participant SCUBA Physical (Inclusive fee for NON -Participant) S270.00 per participant Influenza Vaccinations * $10.00 per participant PPD testing * $18.00 per participant CONSULTATION SERVICES COST Physician Consultation S300.00 per hour Physical Therapy Consultation $100.00 per hour LECTURE & WORKSHOP SERVICES COST Back Workshop $ 600.00 per lecture Nutritional and health related lectures $200.00 per lecture to $500.00 per lecture NCFD Wellness Program 9 9/22/2006 * Fees for Influenza Vaccinations and PPD testing may be adjusted during the term of this agreement based on changes in current market price and availability of the vaccines. The adjusted fee will be determined by the average price of the vaccine or PPD through other local providers, plus 10% for administration. Authorization of the adjusted price and/or the decision to provide these services rests with the NCFD. 4.3.1. Pre -Paid Fees for Services. Any pre -paid fees for service will be reimbursed hack to the City of National City upon disillusion of this agreement. 4.4. Safety/Preventive Services. 4.4.1. SDFFRWP agrees to make available consulting/training in the area of safety/prevention services at the following rates: a. Physician time billed at $300 an hour. b. Non -physician time billed at $100 an hour. 4.5. Prescriptions. It is not the intention of this Agreement or the City of National City that medications shall be dispensed during the scope of the Wellness Program. If the consulting physician identifies a need to prescribe a medication, he/she can provide a prescription at no additional cost, or make a referral to the employee's own physician. The City of National City shall not reimburse either the employee or SD1rhRWP for prescription or non-prescription medications. 4.6. Vision and Audiometric Examinations. SDFFRWP agrees to provide vision and audiometric examinations to NCFD Employees as referenced by guidelines published by the California Department of Motor Vehicles (DMV). 4.7. Respiratory Examinations. SDFFRWP agrees to provide respiratory examinations to NCFD Employees as referenced by guidelines published by the Occupational Safety and Health Administration (OSHA). 4.8. Performance Standards. It is the intent of SDFFRWP and the City of National City to provide quality medical care and other Wellness services for NCFD Employees. To maintain and improve the quality, access, availability, and cost-effectiveness of the services provided under this Agreement, SDFFRWP and the City of National City each agree to use their best efforts to develop means and standards for measuring the performance of SDh>~RWP under the Agreement, including, but not limited to the following: 4.8.1. Measurement of Key Performance Indicators, including time lost from injury, vital signs, body mass index (BMI), cholesterol levels, and subjective surveys of participant's satisfaction. NCFD Wellness Program 10 9/22/2006 4.8.2. Comparison of these indicators with other fire departments as available through the International Association of Fire Fighters (IAFF) Wellness Initiative database. 4.8.3. Comparison of these indicators with other fire departments as available through the San Diego County Fire Chief's Association (to be determined). 4.8.4. Other factors to be established by SDFFRWP and the City of National City. 4.8.5. SDI-I-RWP shall establish a complaint review process to identify and monitor complaints made by NCFD Employees, and review and discuss complaints with the NCFD based on confidentiality and other legal constraints. 4.8.6. SDFFRWP agrees to conduct or cause to be conducted a patient satisfaction survey. SDFFRWP shall continue to consult with the City of National City regarding the substance, procedure and results of each survey. 4.8.7. In addition to the requirements of California law for licensing of professional medical staff, SDFFRWP shall, at least every two years, review the credentials and qualifications of its medical staff, pursuant to procedures established by SDFFRWP. The Credential Review shall include review of patient complaints, satisfaction surveys, site visits, results of quality reviews, utilization management, and peer reviews. 4.9. City of National City's Reservation of Rights. The City of National City reserves the right to review and approve all logos, promotional materials, promotional campaigns, and any and all other materials that represent SDI-FRWP's efforts to publicize and/or promote the Wellness Program on behalf of the NCFD. 4.10. SDFFRWP Representative. SDFFRWP shall designate that the Wellness Officer of SDFFRWP will represent SDFFRWP in all matters pertaining to this Agreement. Section 5. Administrative Services 5.1. Periodic Meetings. Subject to any state and federal privacy laws, SDFFRWP agrees to meet with the NCFD's staff as scheduled to confidentially discuss program issues, utilization of medical specialties, utilization of physical therapy, trends and any topic of interest pertaining to the Wellness Program and SDFFRWP. NCFD Wellness Program 11 9/22/2006 5.2. Work -Related Injuries: Initial Medical Reporting. While it is not the intent of the Wellness Program to diagnose or otherwise treat any suspected work - related injuries, in the course of a Wellness/Fitness evaluation a suspected work - related injury or illness may be discovered. SDFFRWP shall refer all NCFD employees, with a suspected work -related injury or illness, to the NCFD for coordination of medical care, unless a life threatening medical emergency exists that requires medical treatment. SDFFRWP will direct the employee to follow all NCFD procedures for reporting a work related injury or illness. Following any emergency medical treatment, SDFFRWP shall report the treatment to the NCFD for the purposes of follow-up medical treatment. In the case of emergency medical treatment, SDFFRWP shall provide the NCFD with a Doctors First Report of Work Injury or Illness (form 5020) within two days of initial treatment and all billing. SDFFRWP is not authorized to determine causation of any suspected work related injury or illness. 5.3. Work -Related Injuries: Medical Reports and Billings. SDFFRWP shall use those reports, billings and associated forms in a format approved by the NCFD for any and all work related injuries reported. 5.4. Maintenance of Medical Reports. SDFFRWP shall accurately maintain, store and retrieve employee medical files during the period of this Agreement in accordance with all applicable laws and regulations. 5.5. Confidentiality. SDFFRWP shall ensure security of the medical records for all Wellness Program participants and shall ensure compliance with all State and Federal Privacy Laws. At no time shall SIDEI-RWP or San Diego Sports Medicine release confidential medical records to the City of National City without written authorization from the employee. 5.6. Testimony. SDFFRWP shall, upon reasonable notice, submit to depositions and testify at court if requested by the City of National City. 5.7. Return -to -Work Consulting. SDFFRWP shall provide consulting services by working with NCFD staff on returning injured NCFD employees, when appropriate, to modified duty. 5.8. Special Treatment Consulting. SDFFRWP shall provide recommendations to Wellness Participants regarding surgical options, special medical treatments, or other special medical procedures identified during the Wellness exam as requiring such treatment or services. 5.9. Authorization for Patient Referral. SDFFRWP shall insure that the employee is instructed that any referral made to a specialist or hospital will NOT be reimbursed by the Wellness Program unless authorized by both the Medical Director and the Wellness Officer. NCFD Wellness Program 12 9/22/2006 Section 6. Indemnification and Hold Harmless. 6.1. The City of San Diego (City) agrees to defend, indemnify, protect and hold the City of National City and its agents, officers and employees harmless from and against any and all claims asserted or liability established for damages or injuries to any person or property, including injury to NCFD's employees, agents or officers, which arise from or are connected with or are caused or claimed to be caused by the acts or omissions of City and SDFFRWP and its employees in performing the work or services or supplying the materials or equipment under this Agreement, and all expenses, of investigating and defending against same; provided, however, that City's duty to defend, indemnify and hold harmless shall not include any claims or liability arising from the sole negligence or sole willful misconduct of the City of National City, its agents, officers or employees. This shall not prejudice the right of the City of National City to appear in such suit, participate in the defense, and take such actions as may be necessary to protect the interests of the City of National City. If the City of National City chooses, at its own election, to obtain independent legal counsel in defense of any claim against the City of National City, related to the performance of City and SDFFRWP under this Agreement, then City agrees to pay the reasonable value of attorney's fees and costs for such independent legal counsel, however, City shall not be obligated to pay attorney's fees at an hourly rate greater than the hourly rate charged by its defense attorneys in the same matter. City's obligations under this section shall be reduced dollar for dollar by any amounts the City of National City is awarded in such action for attorney's fees and costs. 6.2. The City of National City agrees to defend, indemnify, protect and hold City and it's employees harmless from and against any and all claims asserted or liability established for damages or injuries to any person or property, including injury to City employees, agents or officers, which arise from or are connected with or are caused or claimed to be caused by the sole negligence or sole willful misconduct of the City of National City and its officers or employees in performing the work or services or supplying the materials or equipment under this Agreement, and all expenses, of investigating and defending against same; provided, however, that the City of National City's duty to defend, indemnify and hold harmless shall not include any claims or liability arising from the sole negligence or sole willful misconduct of City or SDFFRWP, or its employees. This shall not prejudice the right of City to appear in such suit, participate in the defense, and take such actions as may be necessary to protect the interests of City. If City chooses, at its own election, to obtain independent legal counsel in defense of any claim against the City of National City, related to the performance of the City of National City under this Agreement, then the City of National City agrees to pay the reasonable value of attorney's fces and costs for such independent legal counsel, however, the City of National City shall not be obligated to pay attorney's fees at an hourly rate greater than the hourly rate charged by its defense attorneys in the same matter. The City of National City's obligations under this NCFD Wellness Program 13 9/22/2006 section shall be reduced dollar for dollar by any amounts City or SDFFRWP is awarded in such action for attorney's fees and costs Section 7. Termination. Unless terminated sooner in accordance with its terms, this Agreement shall terminate as set forth in Item 2. This Agreement may be terminated for any reason by either party giving sixty (60) days written notice to the other party's designated representative, provided that the Indemnification and Duty to Defend provisions in item 6 shall survive such termination, for a period of one year. Notice under this provision shall be communicated in writing in person or by certified mail, return receipt requested as follows: If to SDFt RWP: If to the City of National City: Wellness Officer 6699 Alvarado Road, Suite 101 San Diego, CA 92120 Fire Chief National City Fire Department 140 E. 12th Street Suite A National City, CA 91950 Notice will be deemed to be provided upon the earlier of actual receipt (or refusal to accept receipt) or the fifth business day after deposit in the mail as required in this Agreement. Section 8. Lack of Sufficient Funds. This Agreement shall he terminated immediately if the City of National City does not annually appropriate sufficient funds to the Wellness Program. Section 9. Equal Opportunity. SDFFRWP shall comply with the City of National City's Equal Opportunity Program. Section 10. Drug -Free Workplace. Upon execution of this Agreement and all subsequent extensions, SDFFRWP agrees to comply with any requirements set forth in City of National City policy regarding drug -free workplace. Section 11. Americans with Disabilities Act Statement. NCFD Wellness Program 14 9/22/2006 SDFFRWP shall be responsible for complying with the 1990 Americans with Disabilities Act (ADA). (For specific services and public accommodations, SDFFRWP may contact the Office of the Americans with Disabilities Act, Civil Rights Division, U.S. Department of Justice, P.O. Box 66118, Washington, D.C. 20035-6118; phone number (202) 514-0301.) Section 12. Confidentiality and Internal Use 12.1. City of National City and SDFFRWP agree that all services and work product under this Agreement shall be solely for the informational purposes and internal use of both parties. Parties further agree that such information, services and work product shall not be used by, or circulated, quoted, disclosed, or distributed to, nor shall reference to such services or work product be made to, any person or entity other than the City of National City and SDFFRWP and its staffs except (a) as may be required by law, regulation, judicial or administrative process, or in accordance with applicable professional standards, or in connection with litigation pertaining hereto or (b) to the extent such information shall have otherwise become publicly available. 12.2. To the extent that, in connection with this Agreement, SDFFRWP comes into possession of any proprietary or confidential information of the City of National City, SDFFRWP shall not disclose such information to any third party without the City of National City's consent, except (a) as may be required by law, regulation, judicial or administrative process, or in accordance with applicable professional standards, or in connection with litigation pertaining thereto, or (b) to the extent such information shall have otherwise become publicly available (including, without limitation, any information tiled with any governmental agency and available to the public) other than as the result of a disclosure by SDFFRWP in breach hereof, (c ) becomes available to SDFFRWP on a non -confidential basis from a source other than the City of National City which SD1-FRWP does not believe is prohibited from disclosing such information to SDH-1(WP by obligation to the City of National City, (d) is known by SDFFRWP prior to its receipt from the City of National City without any obligation of confidentiality with respect thereto, or (e) is developed by SDFFRWP independently of any disclosures made by the City of National City to SDFFRWP of such information. Section 14. integration. This Agreement, and all rights and obligations created by this Agreement, shall be in full force and effect whether or not any parties to the Agreement have been succeeded by another entity, and all rights and obligations created by this Agreement shall he vested and binding on any party's successor in interest. Section 15. Non -Assignment. NCFD Wellness Program 15 9/22/2006 SDFFRWP shall not assign the obligations under this Agreement, whether by express assignment or by sale of the company, nor any monies due or to become due, without the City of National City's prior written approval, which approval shall not be held unreasonably. Any assignment in violation of this paragraph shall constitute a Default and is grounds for immediate termination of this Agreement, at the sole discretion of the City of National City. In no event shall any putative assignment create a contractual relationship between the City of National City and any putative assignee. Section 16. Compliance with Controlling Law. SDFFRWP shall comply with all laws, ordinance, regulations, and policies of the federal, state, and local governments applicable to this Agreement. In addition, SDFFRWP shall comply within a reasonable time after receiving written notice by NCFD with all directives issued by the NCFD or its authorized representatives under authority of any laws, statutes, ordinance, rules, or regulations. The laws of the State of California shall govern and control the terms and conditions of this Agreement. Section 17. Jurisdiction and Venue. The venue for any suit or proceeding concerning the Agreement, the interpretation or application of any of its terms, or any related disputes shall he in the County of San Diego, State of California. Section 18. No Waiver. No failure of either the City of National City or SDI±hRWP to insist upon the strict performance by the other of any covenant, term or condition of the Agreement, nor any failure to exercise any right or remedy consequent upon a breach of any covenant, term, or condition of the Agreement, shall constitute a waiver of any such preach or of such covenant, term or condition. No waiver of any breach shall affect or alter this Agreement, and each and every covenant, condition, and term hereof shall continue in full force and effect to any existing or subsequent breach. Section 19. Severability. The unenforceability, invalidity, or illegality of any provision of this Agreement shall not render any other provision of this Agreement unenforceable, invalid, or illegal. Section 20. Drafting Ambiguities. The Parties agree that they are aware they have the right to he advised by counsel with respect to the negotiations, terms and conditions of this Agreement, and the decision whether or not to seek advice of counsel with respect to this Agreement is a decision which is the sole responsibility of each Party. This Agreement shall not he construed in NCFD Wellness Program 16 9/22/2006 favor of or against either Party by reason of the extent to which each Party participated in the drafting of this Agreement. Section 21 . Signatures —Counterparts. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same instrument. This Agreement shall not be effective until the execution and delivery between each of the parties of at least one set of counterparts. The parties authorize each other to detach and combine original signature pages and consolidate them into a single identical original. Any one of such completely executed counterparts shall he sufficient proof of this Agreement. IN WITNESS WHEREOF, this Agreement is executed by the City of National City, acting by and through its Mayor and by SDFFRWP, acting by and through its Wellness Officer. CITY OF NATIONAL CITY Dated: By Nick lnzunza Mayor CITY OF SAN DIEGO FIREFIGHTERS REGIONAL WELLNESS PROGRAM Dated: By Tracy Jarman Fire Chief 1 HEREBY APPROVE the form and legality of this agreement between the City of San Diego Firefighters Regional Wellness Program and National City Fire Department for Wellness Program Services. MICHAEL J. AGUIRRE, CITY ATTORNEY Dated: By Joseph Sanchez Deputy City Attorney NCFD Wellness Program 17 9/22/2006 RESOLUTION NO. 2006 - RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY AUTHORIZING THE MAYOR TO EXECUTE AN AGREEMENT BETWEEN THE CITY OF NATIONAL CITY AND SAN DIEGO FIREFIGHTERS REGIONAL WELLNESS PROGRAM FOR WELLNESS PROGRAM SERVICES WHEREAS, the City of National City's Fire Department seeks to enhance its existing wellness -fitness program; and WHEREAS, the City of National City's Fire Department applied and received approval for grant funds from the Federal Department of Homeland Security; and WHEREAS, the Federal Department of Homeland Security awarded $46,012 or 80% in grant funding to the City of National City to be used to join the San Diego Firefighters Regional Wellness Program; and WHEREAS, the City of National City is required to allocate $11,502 or a 20% match to receive the grant funding; and WHEREAS, the City of National City's Fire Department determined that the San Diego Firefighters Regional Wellness Program has the expertise, experience, and personnel necessary to provide wellness program services required by the City of National City's Fire Department; and WHEREAS, the City of National City and San Diego Firefighters Regional Wellness Program desire to enter into a contractual relationship which makes San Diego Firefighters Regional Wellness Program the health provider agency of the City of National City's Fire Department's Wellness Program. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby authorizes the Mayor to execute the Agreement between the City of National City and San Diego Firefighters Regional Wellness Program for wellness program services. Said agreement is on file in the office of the City Clerk. PASSED and ADOPTED this 21st day of November, 2006. Nick Inzunza, Mayor ATTEST: Michael R. Dalla, City Clerk APPROVED AS TO FORM: George H. Eiser, III City Attorney City of National City Office of the City Clerk 1243 National City Boulevard, National City, CA 91950-4397 Michael R. Della, CMC - City Clerk (619) 336-4228 Fax: (619) 336-4229 February 20, 2007 Wellness Officer San Diego Firefighters Regional Wellness Program 6699 Alvarado Road, Suite 101 San Diego, CA 92120 Dear Sir or Madam, On November 21, 2006, Resolution No. 2006-231 was passed and adopted by the City Council of National City, authorizing the Mayor to execute an Agreement with the San Diego Firefighters Regional Wellness Program. We are enclosing for your records a certified copy of the above Resolution and a fully executed copy of the agreement. Sincerely, Michael R. Dalla, CMC City Clerk Enclosure cc: Fire Department ® Recycled Paper