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HomeMy WebLinkAbout2012 CON San Diego Sports Medicine & Family Health Center - Wellness Program ServicesAGREEMENT BY AND BETWEEN THE CITY OF NATIONAL CITY AND SAN DIEGO SPORTS MEDICINE AND FAMILY HEALTH CENTER 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 1243 National City Boulevard, National City, CA, 91950 and San Diego Sports Medicine & Family Health Center (SDSMFHC), a Medical Corporation, with its principal place of business located at 6699 Alvarado Road, Suite 101, San Diego, CA 92120. RECITALS WHEREAS, the NCFD will 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 SDSMFHC has the expertise, experience, qualifications 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.htm1). 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 SDSMFHC desires to enter into a contractual relationship which makes SDSMFHC 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 SDSMFHC agree to pay and bill respectively in accordance with the rates, fees and restrictions set forth in Item 1.2, 4.1,4.2.9, 4.3, and 4.4 of this agreement. 1.2. SDSMFHC shall provide an invoice for services rendered during a calendar month to the NCFD by the 10th day of the next month. The City of National City will pay the invoice within 30 days after receiving the invoice. Invoices are subject to approval by the City prior to payment. Services will be itemized, and presented in the following categories: 2012 Agreement Wellness Program Services 1 City of National City and SD Sports Medicine & Family Health Center 1.2.1. Clinical services 1.2.2. Consultation services 1.2.3. Lecture and workshop services Section 2. Term. 2.1. Term. The term of this Agreement shall be for a period of five (5) years from the effective date hereof. 2.2. Options to Renew. The City of National City shall have the option to renew this agreement 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, 4.29, 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 its 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 SDSMFHC, such notice shall be sent by mail addressed to: Katie Rusk, Project Manager San Diego Sports Medicine & Family Health Center 6699 Alvarado Road, Suite 101 San Diego, CA 92120 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. SDSMFHC Obligations. 4.1. Wellness Program Services. SDSMFHC 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. SDSMFHC 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 and Rehabilitation, Behavioral Health and Data Collection. SDSMFHC agrees to provide the following services and/or collection of information in addition to those services set forth in Appendix A: a. Prior to Medical Evaluation. SDSMFHC agrees to provide all the necessary forms, reports, and documentation for the requested information listed below: 2012 Agreement 2 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center • 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. • Directions to facilities. SDSMFHC 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. • TSH screening (cardiovascular risk screening) 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 and Nutritional Risk Assessment. • Hearing and Vision screening. • Cancer screening, as appropriate, at an additional cost, including PSA, Hemocult, 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. 2012 Agreement 3 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center • Grip Strength utilizing a hand dynamometer. • Leg Strength using the Jackson Strength Evaluation System. • Arm Strength using the Jackson Strength Evaluation System. • Functional Movement Screening. • Flexibility evaluation. • 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, exercise consult, nutrition consult. • 45 minutes with Strength and Conditioning Personnel: 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. 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. • Suggested exercise program. • Comprehensive wellness/fitness program recommendations. • Firefighter Physical Performance Standard Score. • Physical Fitness Age Assessment. 2012 Agreement 4 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center g. Personalized written Health and Wellness Report. Each firefighter will receive an individual packet of the medical and fitness evaluation that outlines his/her results. 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. SDSMFHC 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. i. Data Collection. SDSMFHC will provide scientific and technical support related to data collection and analysis. Data shall be collected an stored on the electronic database designed by SDSMFHC specifically for the Services to be performed under this agreement. Data Collection services shall include the following: 1) Storage of past, current and future data on a secure server. Data shall be backed up weekly and kept at a remote location. 2) Analysis of data for errors, omissions and outliers. Statistical analysis shall be performed to summarize the demographic medical fitness outcomes on each individual as well as the group as a whole. 3) Development of an annual report which shall be presented to Senior NCFD Staff which identifies health trends and concerns. 4) Development of new strategies for data collection and reporting. 5) Evaluating and analyzing data for individual and group disease management. 6) Integrating data with other fire departments in a confidential manner in compliance with all federal and state law. j. Education Program. SDSMFHC will provide educational hours over the year for Wellness participants. The Education component will be multifaceted in its delivery. The intent of the Education Component is to address those areas of interest and concern for the health and fitness of the National City Firefighters. The Education Component shall include the following: 1) Nutrition station as part of the annual physical; 2) Biannual newsletter; 3) Stations visits which will include, but not be limited to educational sessions on exercise, fitness, nutrition and health related topics. 4) Individual counseling for high risk individuals and those with specific nutrition and exercise needs; 5) Development of educational material for Personal Profile and group education projects (i.e. Fiber challenge, Big Burn Challenge, Body Blast workout, Health Fire Fighter recipes; 2012 Agreement 5 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center 6) Providing resources and Consultant staff on health and fitness related issues (i.e. return to work issues, training issues, Cross Fit, medical advice regarding injury treatment and more) 7) Providing a Registered Dietician to help those individuals with high risk nutritional/health related problems. 8) Providing an Athletic Trainer to help those individuals with specific injury related problems identified by Physician. The Education Program consists of initial education, as well as recurrent education. Fees for the initial portion of the Educational Program are included in the set fee for Medical and Fitness Exams for Wellness Participants. k. 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: Evaluation metals 1) All of the components and procedures of the Respiratory Fit 2) Blood testing consisting of CBC, chemistry panel and heavy 3) (arsenic, mercury and lead) and archiving of the results on entrance into the Hazardous Materials Program. 4) Cholinesterase on a yearly basis. 5) Any additional blood testing required for specific or known exposure 6) EKG 7) Treadmill 1. Immunizations. SDFFRWP agrees to offer NCFD, at NCFD discretion, 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 in 4.3. 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 be present to administer or supervise administration of the immunization or PPD. The PPD will be read within 48 to 72 hours by a certified 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 (that Participants provide) 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 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. All immunizations will be preauthorized by the City of National City. 2012 Agreement 6 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center 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 location: SAN DIEGO FIREFIGHTERS REGIONAL WELLNESS CENTER (Hosted by San Diego Sports Medicine and Family Health Center) 6699 Alvarado Road, Suite 101, San Diego, CA 92120 4.2.2. Staffing and Hours of Operation. SDSMFHC shall maintain a medical facility staffed by licensed physicians and technicians during business hours. In agreement with the City of National City, SDSMFHC shall commit to the days and hours of operation to comply with the goals of the Wellness Program and the Wellness Initiative. 4.2.3. Priority Appointments. SDSMFHC shall maintain a licensed physician or physician assistant available to examine and treat NCFD Employees that have arrived for their appointment. 4.2.4. Medical Specialists. SDSMFHC 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. 4.2.5. Medical Consultants. SDSMFHC shall maintain a list of medical specialty consultants for referral to NCFD Employees. 4.2.6. Other Medical Services. SDSMFHC shall provide radiological facilities on -site at the Wellness Center to facilitate comprehensive examinations. 4.2.7. Weekend and Evenings. The Wellness Center will not operate on weekends or evenings. 4.2.8. 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. 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. 4.2.9. 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. 4.3. Pricing of Services. The following prices have been established at the initiation of this agreement, and as referred in items 4.1, 4.3. The fees for all services excluding labs and 2012 Agreement 7 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center vaccinations shall be increased at a rate of 5% of the cost from the prior fiscal year. Influenza Vaccinations, PPD testing and Labs will be priced based on the current market value. CLINICAL SERVICES COST Medical Fitness Evaluation Pre -Employment Physical -Public Safety** $1209.00 per participant $435.00 per participant Administration Included Facilities and Maintenance Included DMV exam and paperwork only $100.00 per participant Respiratory Fit Exam only $125.00 per participant Hazardous Materials Technician Physical $660.00 per participant Influenza Vaccinations $20.00 per participant* PPD testing $18.00 per participant* Immunizations as Requested Hepatitis A Vaccine Hepatitis B Vaccine Hepatitis B Titer Tetanus/Adacel $95.00 per participant* $70.00 per participant* $70.00 per participant* $65.00 per participant* LABS COST General Labs (No MedFit Eval) Hearing (No MedFit Eval) PSA Hemocult Pap Smear Mammogram Chest Xray (No MedFit Eval) Cholinesterase Resting EKG (No MedFit Eval) Treadmill (No MedFit Eval) Heavy Metals Testing $40 per participant $40 per participant $40 per participant $20 per participant $75 per participant $175 per participant $60 per participant $60 per participant $50 per participant $225 per participant $180 per participant CONSULTATION SERVICES COST Physician Consultation $300.00 per hour Physical Therapy Consultation Physical Therapy Services $100.00 per hour $75.00 per hour 2012 Agreement 8 Wellness Program Services City of National City and SD Sports Medicine & Family Health Center LECTURE & WORKSHOP SERVICES COST Back Workshop $600.00 per lecture Nutritional and health related lectures $200.00 per lecture to $500.00 per lecture * Fees 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. The decision to provide these services rests with the NCFD. ** Positions agreement. See attached Appendix A - Pre Employment Physicals -Group 1 Public Safety 4.3.1. Pre -Paid Fees for Services. Any pre -paid fees for service will be reimbursed back to the City of National City within 10 days of dissolution of this 4.4. Safety/Preventive Services. 4.4.1. SDSMFHC 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, until the employee can follow-up with his/her own physician, or make a referral to the employee's own physician. The City of National City shall not reimburse either the employee or SDSMFHC for prescription or non-prescription medications. 4.6. Vision and Audiometric Examinations. SDSMFHC 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. SDSMFHC 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 SDSMFHC 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, SDSMFHC and the City of National City each agree to use their best efforts to develop means and standards for measuring the performance of NCFD under the Agreement, including, but not limited to the following: 2012 Agreement 9 City of National City and Wellness Program Services SD Sports Medicine & Family Ilealth Center 4.8.1. Measurement of Key Performance Indicators, including Workers' Compensation savings, vital signs, 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). 4.8.4. Other factors to be established by SDSMFHC and the City of National City. 4.9. SDSMFHC Representative. SDSMFHC shall designate Richard Parker, D.O, FAOASM, to represent SDSMFHC in all matters pertaining to this Agreement. Section 5. Administrative Services. 5.1. Periodic Meetings. Subject to any state and federal privacy laws, SDSMFHC, 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. 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. SDSMFHC 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. SDSMFHC will direct the employee to follow all NCFD procedures for reporting a work related injury or illness. Following any emergency medical treatment, SDSMFHC shall report the treatment to the NCFD for the purposes of follow-up medical treatment. In the case of emergency medical treatment, SDSMFHC 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. SDSMFHC is not authorized to determine causation of any suspected work related injury or illness. 5.3. Work -Related Injuries: Medical Reports and Billings. SDSMFHC 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. SDSMFHC 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. SDSMFHC 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 SDSMFHC release confidential medical records to the City of National City without written authorization from the employee. 2012 Agreement 10 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center 5.6. Testimony. SDSMFHC shall, upon reasonable notice, submit to depositions and testify at court if requested by the City of National City at the contracted physician consulting rate in 4.3. 5.7. Return -to -Work Consulting. SDSMFHC shall provide consulting services by working with NCFD staff on returning injured NCFD employees, when appropriate, to modified duty at the contracted physician consulting rate in 4.3. 5.8. Special Treatment Consulting. SDSMFHC 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 at the contracted physician consulting rate in 4.3. 5.9. Authorization for Patient Referral. SDSMFHC 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 Project Manager. Section 6. Indemnification and Hold Harmless. 6.1. SDSMFHC 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 sole negligence or sole willful misconduct of SDSMFHC 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 SDSMFHC'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 by SDSMFHC under this Agreement, then the City agrees to pay the reasonable value of attorney's fees and costs for such independent legal counsel, however, the SDSMFHC 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. SDSMFHC'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 SDSMFHC 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 SDSMFHC 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 agents, 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 2012 Agreement 11 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center negligence or sole willful misconduct of SDSMFHC its employees, agents and officers. This shall not prejudice the right of SDSMFHC to appear in such suit, participate in the defense, and take such actions as may be necessary to protect the interests of the SDSMFHC. If SDSMFHC chooses, at its own election, to obtain independent legal counsel in defense of any claim against the SDSMFHC, 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 fees 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 section shall be reduced dollar for dollar by any amounts SDSMFHC is awarded in such action for attorney's fees and costs. Section 7. Termination. This Agreement shall renew annually as set forth in Item 2. This Agreement may be terminated for any reason by either party giving ninety (90) 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 SDSMFHC: Richard Parker, D.O., FAOASM San Diego Sports Medicine & Family Health Center 6699 Alvarado Road, Suite 101 San Diego, CA 92120 If to City of National City: National City Fire Department 1243 National City Boulevard National City, CA 91950 Section 8. Equal Opportunity. SDSMFHC shall comply with the City of National City's Equal Opportunity Program. Section 9. Drug -Free Workplace. Upon execution of this Agreement and all subsequent extensions, SDSMFHC agrees to comply with any requirements set forth in City of National City policy regarding drug -free workplace. Section 10. Americans with Disabilities Act Statement. SDSMFHC shall be responsible for complying with the 1990 Americans with Disabilities Act (ADA). (For specific services and public accommodations, SDSMFHC may contact the Office of the Americans with Disabilities Act, Civil Rights Division, U.S. District of Justice, P.O. Box 66118, Washington, D.C. 20035- 6118; phone number (202) 514-0301.) Section 11. 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 party's successor in interest. 2012 Agreement 12 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center Section 12. Compliance with Controlling Law. SDSMFHC shall comply with all laws, ordinance, regulations, and policies of the federal, state, and local governments applicable to this Agreement. In addition, SDSMFHC 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 13. 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 14. No Waiver. No failure of either the City of National City or SDSMFHC 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 15. 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 16. Drafting Ambiguities. The Parties agree that they are aware they have the right to be 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. Section 17. 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 SDSMFHC, acting by and through its Wellness Director. --- Signature Page to Follow --- 2012 Agreement 13 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center CITY OF NATIONAL CITY Dated: /01/ �c;/ By: APPROVED AS TO FORM: C1dia itua Silva City Att Rd4f Mor"risSn Mayor SAN DIEGO SPORTS MEDICINE AND FAMILY HEALTH CENTER Dated: /0-Z2- i2— By:-.__—_ /Q/L3/ja Dated: By: Richard Parker, D.O., F.A.O.A.S.M. Wellness Director Chief Financial Officer 2012 Agreement 14 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center APPENDIX A Pre -employment Physicals Group 1 Public Safety Positions The pre -employment physicals may be utilized by the City of National City to examine new firefighters. The examination will include the following: 1. Review of personal and family health history (questionnaire). 2. Complete physical examination by physician including orthopedic evaluation. 3. Vital signs. 4. Eye tests, near and distant vision, lateral and vertical phorias, color vision using Ishihara plates, also Farnsworth color vision test (D-15) when indicated. 5. Hearing and audiometric performed in audio booth. 6. Radiological studies: a. Two (2) view x-ray exam of the chest (heart and lungs). b. Three (3) view lumbar spine x-rays. 7. Firefighters only: respiratory questionnaire and test with certification. 8. Laboratory studies. a. CBC b. Blood chemistry i. Uric Acid ii. Potassium iii. Phosphatese Chloride iv. Total Protein v. Glucose vi. Nitrogen (BUN) vii. LDH viii. Creatinine ix. LFT's - transaminase, (SGOT and SGPT) c. Urinalysis d. Drug Screen - Urine 2012 Agreement 15 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center RESOLUTION NO. 2012 — 218 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY WAIVING THE FORMAL BID PROCESS AND AUTHORIZING THE MAYOR TO EXECUTE A FIVE-YEAR AGREEMENT BETWEEN THE CITY OF NATIONAL CITY AND SAN DIEGO SPORTS MEDICINE AND FAMILY HEALTH CENTER FOR WELLNESS PROGRAM SERVICES TO THE NATIONAL CITY FIRE DEPARTMENT WHEREAS, on March 16, 2010, the City Council adopted Resolution No. 2010- 38, approving an Agreement with San Diego Sports Medicine and Family Health Center, making San Diego Sports Medicine and Family Health Center the health provider agency of the National City Fire Department's Wellness Program; and WHEREAS, on April 5, 2011, the City Council adopted Resolution 2011-77, approving the First Amendment to the Agreement to extend the original 2010 Agreement for a term of one year through April 15, 2012; and WHEREAS, with the expiration of the 2010 Agreement, NCFD desires to enter into an agreement for wellness program services; and WHEREAS, in the last three years, formal bid process attempts by another neighboring city (to wit: the City of San Diego) did not yield any other qualified service providers because San Diego Sports Medicine and Family Health Center is uniquely qualified; and WHEREAS, because there are no other known providers of this service and there is no adequate substitute, no further purpose would be served, nor would there be a competitive advantage, to bidding. As authorized by National City Municipal Code section 2.60.220(B), it is requested that the City Council declare that special circumstances exist, and that it is in the City's best interest to enter into an Agreement with San Diego Sports Medicine and Family Health Center for wellness program services. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby waives the formal bid process and authorizes the Mayor to execute a Five - Year Agreement between the City of National City and San Diego Sports Medicine and Family Health Center for Wellness Program for wellness program services. Said Agreement is on file in the office of the City Clerk. PASSED and ADOPTED this 30th day of October, 2012. ATTEST: Michael R. Dalla, ity Clerk n Morrison, Mayor APPROVED AS TO FORM: soh C-u•aG 'uaSilva City Atto Passed and adopted by the Council of the City of National City, California, on October 30, 2012 by the following vote, to -wit: Ayes: Councilmembers Morrison, Natividad, Rios, Sotelo-Solis, Zarate. Nays: None. Absent: None. Abstain: None. AUTHENTICATED BY: RON MORRISON Mayor of the City of National City, California N City Clerk of the CityNational City, California By: Deputy I HEREBY CERTIFY that the above and foregoing is a full, true and correct copy of RESOLUTION NO. 2012-218 of the City of National City, California, passed and adopted by the Council of said City on October 30, 2012. City Clerk of the City of National City, California By: Deputy CITY OF NATIONAL CITY, CALIFORNIA COUNCIL AGENDA STATEMENT MEETING DATE: October 30, 2012 ITEM TITLE: AGENDA ITEM NO. 10 Resolution of the City Council of the City of National City Authorizing Staff to waive the formal bid process and authorize the Mayor to sign a 5 year Agreement between the City of National City and San Diego Sports Medicine and Family Health Center for Wellness Program Services. (Fire) PREPARED BY: Walter Amedee DEPARTMENT: Fi PHONE: 619-336-4556 APPROVED BY: _ EXPLANATION: Over the last six years, the National City Fire Department (NCFD) has contracted with the San Diego Sports Medicine and Family Health Center (SDSMFHC) for wellness program services. An extension to the original Agreement was signed on March 16, 2010, but has recently expired. As a result, the NCFD would now like to sign a new 5 year Agreement. As allowed by Purchasing Ordinance 2.60.110 - Formal bidding procedure —Generally Based: Formal competitive bidding may be waived by the city council, or the city manager within the limits of contracting authority, where it has been determined that: (1) competitive bidding is or would be impractical or impossible. In the last three years, formal bid process attempts by the City of San Diego did not yield any other qualified service providers, because SDSMFHC is uniquely qualified. There are no other providers of this type of service, and there is no adequate other substitute for what the NCFD needs; and because there are no other sources of this service, there would be no competitive advantage to bidding. Staff believes it is in the City's best interest to take advantage of this opportunity and would ask the City Council to waive the formal bid process. At the Council meeting on June 19, 2012, the City Council budgeted $45,000 for the NCFD to continue to participate in the Wellness Program. In order to participate in the Wellness Program, the NCFD needs to have an Agreement in place in order participate. Staff recommends the City Council waive the formal bid process and authorize the Mayor to sign a 5 year greement with the SDSMFHC. FINANCIAL STATEMENT: APPROVED: f Finance ACCOUNT NO. 130-412-125-299-0000 APPROVED: MIS Minor impact; the City Council budgeted $45,000 for the NCFD to continue to participate in the SDSMFHC Wellness Program. ENVIRONMENTAL REVIEW: ORDINANCE: INTRODUCTION: FINAL ADOPTION: STAFF RECOMMENDATION: Staff recommends the City Council waive the formal bid process and authorize the Mayor to sign a 5 year Agreement with the San Diego Sports Medicine and Family Health Center. BOARD / COMMISSION RECOMMENDATION: TTACHMENTS: It San Diego Sports Medicine and Family Health Center Agreement 2. Resolution • • • RESOLUTION NO. 2012 — RESOLUTION OF THE CITY COUNCIL OF THE CITY OF NATIONAL CITY WAIVING THE FORMAL BID PROCESS AND AUTHORIZING THE MAYOR TO EXECUTE A FIVE-YEAR AGREEMENT BETWEEN THE CITY OF NATIONAL CITY AND SAN DIEGO SPORTS MEDICINE AND FAMILY HEALTH CENTER FOR WELLNESS PROGRAM SERVICES TO THE NATIONAL CITY FIRE DEPARTMENT WHEREAS, on March 16, 2010, the City Council adopted Resolution No. 2010- 38, approving an Agreement with San Diego Sports Medicine and Family Health Center, making San Diego Sports Medicine and Family Health Center the health provider agency of the National City Fire Department's Wellness Program; and WHEREAS, on April 5, 2011, the City Council adopted Resolution 2011-77, approving the First Amendment to the Agreement to extend the original 2010 Agreement for a term of one year through April 15, 2012; and WHEREAS, with the expiration of the 2010 Agreement, NCFD desires to enter into an agreement for wellness program services; and WHEREAS, in the last three years, formal bid process attempts by another neighboring city (to wit: the City of San Diego) did not yield any other qualified service providers because San Diego Sports Medicine and Family Health Center is uniquely qualified; and WHEREAS, because there are no other known providers of this service and there is no adequate substitute, no further purpose would be served, nor would there be a competitive advantage, to bidding. As authorized by National City Municipal Code section 2.60.220(B), it is requested that the City Council declare that special circumstances exist, and that it is in the City's best interest to enter into an Agreement with San Diego Sports Medicine and Family Health Center for wellness program services. NOW, THEREFORE, BE IT RESOLVED that the City Council of the City of National City hereby waives the formal bid process and authorizes the Mayor to execute a Five - Year Agreement between the City of National City and San Diego Sports Medicine and Family Health Center for Wellness Program for wellness program services. Said Agreement is on file in the office of the City Clerk. PASSED and ADOPTED this 30th day of October, 2012. Ron Morrison, Mayor ATTEST: APPROVED AS TO FORM: Michael R. Dalla, City Clerk Claudia Gacitua Silva City Attorney AGREEMENT BY AND BETWEEN THE CITY OF NATIONAL CITY AND SAN DIEGO SPORTS MEDICINE AND FAMILY HEALTH CENTER 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 1243 National City Boulevard, National City, CA, 91950 and San Diego Sports Medicine & Family Health Center (SDSMFHC), a Medical Corporation, with its principal place of business located at 6699 Alvarado Road, Suite 101, San Diego, CA 92120. RECITALS WHEREAS, the NCFD will 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 SDSMFHC has the expertise, experience, qualifications 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.iaf£org/safe/wellness2.html). 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 SDSMFHC desires to enter into a contractual relationship which makes SDSMFHC 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 SDSMFHC agree to pay and bill respectively in accordance with the rates, fees and restrictions set forth in Item 1.2, 4.1,4.2.9, 4.3, and 4.4 of this agreement. 1.2. SDSMFHC shall provide an invoice for services rendered during a calendar month to the NCFD by the l 0th day of the next month. The City of National City will pay the invoice within 30 days after receiving the invoice. Invoices are subject to approval by the City prior to payment. Services will be itemized, and presented in the following categories: 2012 Agreement 1 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center 1.2.1. Clinical services 1.2.2. Consultation services 1.2.3. Lecture and workshop services Section 2. Term. 2.1. Term. The term of this Agreement shall be for a period of five (5) years from the effective date hereof. 2.2. Options to Renew. The City of National City shall have the option to renew this agreement 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, 4.29, 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 its 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 SDSMFHC, such notice shall be sent by mail addressed to: Katie Rusk, Project Manager San Diego Sports Medicine & Family Health Center 6699 Alvarado Road, Suite 101 San Diego, CA 92120 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. SDSMFHC Obligations. 4.1. Wellness Program Services. SDSMFHC 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. SDSMFHC 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 and Rehabilitation, Behavioral Health and Data Collection. SDSMFHC agrees to provide the following services and/or collection of information in addition to those services set forth in Appendix A: a. Prior to Medical Evaluation. SDSMFHC agrees to provide all the necessary forms, reports, and documentation for the requested information listed below: 2012 Agreement 2 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center • 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. • Directions to facilities. SDSMFHC 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. • TSH screening (cardiovascular risk screening) 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 and Nutritional Risk Assessment. • Hearing and Vision screening. • Cancer screening, as appropriate, at an additional cost, including PSA, Hemocult, 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. 2012 Agreement 3 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center • Grip Strength utilizing a hand dynamometer. • Leg Strength using the Jackson Strength Evaluation System. • Arm Strength using the Jackson Strength Evaluation System. • Functional Movement Screening. • Flexibility evaluation. • 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, exercise consult, nutrition consult. • 45 minutes with Strength and Conditioning Personnel: 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. 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. • Suggested exercise program. • Comprehensive wellness/fitness program recommendations. • Firefighter Physical Performance Standard Score. • Physical Fitness Age Assessment. 2012 Agreement 4 City of National City and Wellness Program Services SD Sports Medicine & Family I-lealth Center g. Personalized written Health and Wellness Report. Each firefighter will receive an individual packet of the medical and fitness evaluation that outlines his/her results. 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. SDSMFHC 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. i. Data Collection. SDSMFHC will provide scientific and technical support related to data collection and analysis. Data shall be collected an stored on the electronic database designed by SDSMFHC specifically for the Services to be performed under this agreement. Data Collection services shall include the following: 1) Storage of past, current and future data on a secure server. Data shall be backed up weekly and kept at a remote location. 2) Analysis of data for errors, omissions and outliers. Statistical analysis shall be performed to summarize the demographic medical fitness outcomes on each individual as well as the group as a whole. 3) Development of an annual report which shall be presented to Senior NCFD Staff which identifies health trends and concerns. 4) Development of new strategies for data collection and reporting. 5) Evaluating and analyzing data for individual and group disease management. 6) Integrating data with other fire departments in a confidential manner in compliance with all federal and state law. j. Education Program. SDSMFHC will provide educational hours over the year for Wellness participants. The Education component will be multifaceted in its delivery. The intent of the Education Component is to address those areas of interest and concern for the health and fitness of the National City Firefighters. The Education Component shall include the following: 1) Nutrition station as part of the annual physical; 2) Biannual newsletter; 3) Stations visits which will include, but not be limited to educational sessions on exercise, fitness, nutrition and health related topics. 4) Individual counseling for high risk individuals and those with specific nutrition and exercise needs; 5) Development of educational material for Personal Profile and group education projects (i.e. Fiber challenge, Big Burn Challenge, Body Blast workout, Health Fire Fighter recipes; 2012 Agreement 5 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center 6) Providing resources and Consultant staff on health and fitness related issues (i.e. return to work issues, training issues, Cross Fit, medical advice regarding injury treatment and more) 7) Providing a Registered Dietician to help those individuals with high risk nutritional/health related problems. 8) Providing an Athletic Trainer to help those individuals with specific injury related problems identified by Physician. The Education Program consists of initial education, as well as recurrent education. Fees for the initial portion of the Educational Program are included in the set fee for Medical and Fitness Exams for Wellness Participants. k. 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: Evaluation metals 1) All of the components and procedures of the Respiratory Fit 2) Blood testing consisting of CBC, chemistry panel and heavy 3) (arsenic, mercury and lead) and archiving of the results on entrance into the Hazardous Materials Program. 4) Cholinesterase on a yearly basis. 5) Any additional blood testing required for specific or known exposure 6) EKG 7) Treadmill 1. Immunizations. SDFFRWP agrees to offer NCFD, at NCFD discretion, 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 in 4.3. 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 be present to administer or supervise administration of the immunization or PPD. The PPD will be read within 48 to 72 hours by a certified 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 (that Participants provide) 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 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. All immunizations will be preauthorized by the City of National City. 2012 Agreement 6 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center 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 location: SAN DIEGO FIREFIGHTERS REGIONAL WELLNESS CENTER (Hosted by San Diego Sports Medicine and Family Health Center) 6699 Alvarado Road, Suite 101, San Diego, CA 92120 4.2.2. Staffing and Hours of Operation. SDSMFHC shall maintain a medical facility staffed by licensed physicians and technicians during business hours. In agreement with the City of National City, SDSMFHC shall commit to the days and hours of operation to comply with the goals of the Wellness Program and the Wellness Initiative. 4.2.3. Priority Appointments. SDSMFHC shall maintain a licensed physician or physician assistant available to examine and treat NCFD Employees that have arrived for their appointment. 4.2.4. Medical Specialists. SDSMFHC 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. 4.2.5. Medical Consultants. SDSMFHC shall maintain a list of medical specialty consultants for referral to NCFD Employees. 4.2.6. Other Medical Services. SDSMFHC shall provide radiological facilities on -site at the Wellness Center to facilitate comprehensive examinations. 4.2.7. Weekend and Evenings. The Wellness Center will not operate on weekends or evenings. 4.2.8. 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. 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. 4.2.9. 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. 4.3. Pricing of Services. The following prices have been established at the initiation of this agreement, and as referred in items 4.1, 4.3. The fees for all services excluding labs and 2012 Agreement 7 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center vaccinations shall be increased at a rate of 5% of the cost from the prior fiscal year. Influenza Vaccinations, PPD testing and Labs will be priced based on the current market value. CLINICAL SERVICES COST Medical Fitness Evaluation Pre -Employment Physical -Public Safety** $1209.00 per participant $435.00 per participant Administration Included Facilities and Maintenance Included DMV exam and paperwork only $100.00 per participant Respiratory Fit Exam only $125.00 per participant Hazardous Materials Technician Physical $660.00 per participant Influenza Vaccinations $20.00 per participant* PPD testing $18.00 per participant* Immunizations as Requested Hepatitis A Vaccine $95.00 per participant* Hepatitis B Vaccine $70.00 per participant* Hepatitis B Titer $70.00 per participant* Tetanus/Adacel $65.00 per participant* LABS COST General Labs (No MedFit Eval) Hearing (No MedFit Eval) PSA Hemocult Pap Smear Mammogram Chest Xray ( No MedFit Eval) Cholinesterase Resting EKG (No MedFit Eval) Treadmill (No MedFit Eval) Heavy Metals Testing $40 per participant $40 per participant $40 per participant $20 per participant $75 per participant $175 per participant $60 per participant $60 per participant $50 per participant $225 per participant $180 per participant CONSULTATION SERVICES COST Physician Consultation $300.00 per hour Physical Therapy Consultation Physical Therapy Services $100.00 per hour $75.00 per hour 2012 Agreement 8 Wellness Program Services City of National City and SD Sports Medicine & Family Health Center LECTURE & WORKSHOP SERVICES COST Back Workshop $600.00 per lecture Nutritional and health related lectures $200.00 per lecture to $500.00 per lecture * Fees 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. The decision to provide these services rests with the NCFD. ** Positions agreement. See attached Appendix A - Pre Employment Physicals -Group 1 Public Safety 4.3.1. Pre -Paid Fees for Services. Any pre -paid fees for service will be reimbursed back to the City of National City within 10 days of dissolution of this 4.4. Safety/Preventive Services. 4.4.1. SDSMFHC 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, until the employee can follow-up with his/her own physician, or make a referral to the employee's own physician. The City of National City shall not reimburse either the employee or SDSMFHC for prescription or non-prescription medications. 4.6. Vision and Audiometric Examinations. SDSMFHC 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. SDSMFHC 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 SDSMFHC 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, SDSMFHC and the City of National City each agree to use their best efforts to develop means and standards for measuring the performance of NCFD under the Agreement, including, but not limited to the following: 2012 Agreement 9 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center 4.8.1. Measurement of Key Performance Indicators, including Workers' Compensation savings, vital signs, 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 Chief's Association (to be determined). 4.8.4. Other factors to be established by SDSMFHC and the City of National City. 4.9. SDSMFHC Representative. SDSMFHC shall designate Richard Parker, D.O, FAOASM, to represent SDSMFHC in all matters pertaining to this Agreement. Section 5. Administrative Services. 5.1. Periodic Meetings. Subject to any state and federal privacy laws, SDSMFHC 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. 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. SDSMFHC 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. SDSMFHC will direct the employee to follow all NCFD procedures for reporting a work related injury or illness. Following any emergency medical treatment, SDSMFHC shall report the treatment to the NCFD for the purposes of follow-up medical treatment. In the case of emergency medical treatment, SDSMFHC 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. SDSMFHC is not authorized to determine causation of any suspected work related injury or illness. 5.3. Work -Related Injuries: Medical Reports and Billings. SDSMFHC 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. SDSMFHC 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. SDSMFHC 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 SDSMFHC release confidential medical records to the City of National City without written authorization from the employee. 2012 Agreement 10 City of National City and Wellness Progam Services SD Sports Medicine & Family Health Center 5.6. Testimony. SDSMFHC shall, upon reasonable notice, submit to depositions and testify at court if requested by the City of National City at the contracted physician consulting rate in 4.3. 5.7. Return -to -Work Consulting. SDSMFHC shall provide consulting services by working with NCFD staff on returning injured NCFD employees, when appropriate, to modified duty at the contracted physician consulting rate in 4.3. 5.8. Special Treatment Consulting. SDSMFHC 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 at the contracted physician consulting rate in 4.3. 5.9. Authorization for Patient Referral. SDSMFHC 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 Project Manager. Section 6. Indemnification and Hold Harmless. 6.1. SDSMFHC 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 sole negligence or sole willful misconduct of SDSMFHC 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 SDSMFHC'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 by SDSMFHC under this Agreement, then the City agrees to pay the reasonable value of attorney's fees and costs for such independent legal counsel, however, the SDSMFHC 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. SDSMFHC'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 SDSMFHC 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 SDSMFHC 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 agents, 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 2012 Agreement 1 1 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center negligence or sole willful misconduct of SDSMFHC its employees, agents and officers. This shall not prejudice the right of SDSMFHC to appear in such suit, participate in the defense, and take such actions as may be necessary to protect the interests of the SDSMFHC. If SDSMFHC chooses, at its own election, to obtain independent legal counsel in defense of any claim against the SDSMFHC, 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 fees 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 section shall be reduced dollar for dollar by any amounts SDSMFHC is awarded in such action for attomey's fees and costs. Section 7. Termination. This Agreement shall renew annually as set forth in Item 2. This Agreement may be terminated for any reason by either party giving ninety (90) 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 SDSMFHC: Richard Parker, D.O., FAOASM San Diego Sports Medicine & Family Health Center 6699 Alvarado Road, Suite 101 San Diego, CA 92120 If to City of National City: National City Fire Department 1243 National City Boulevard National City, CA 91950 Section 8. Equal Opportunity. SDSMFHC shall comply with the City of National City's Equal Opportunity Program. Section 9. Drug -Free Workplace. Upon execution of this Agreement and all subsequent extensions, SDSMFHC agrees to comply with any requirements set forth in City of National City policy regarding drug -free workplace. Section 10. Americans with Disabilities Act Statement. SDSMFHC shall be responsible for complying with the 1990 Americans with Disabilities Act (ADA). (For specific services and public accommodations, SDSMFHC may contact the Office of the Americans with Disabilities Act, Civil Rights Division, U.S. District of Justice, P.O. Box 66118, Washington, D.C. 20035- 6118; phone number (202) 514-0301.) Section 11. 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 party's successor in interest. 2012 Agreement 12 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center Section 12. Compliance with Controlling Law. SDSMFHC shall comply with all laws, ordinance, regulations, and policies of the federal, state, and local governments applicable to this Agreement. In addition, SDSMFHC 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 13. 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 14. No Waiver. No failure of either the City of National City or SDSMFHC 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 15. 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 16. Drafting Ambiguities. The Parties agree that they are aware they have the right to be 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. Section 17. 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 SDSMFHC, acting by and through its Wellness Director. --- Signature Page to Follow --- 2012 Agreement 13 City of National City and Wellness Program Services SD Sports Medicine & Family Health Center CITY OF NATIONAL CITY Dated: By: Ron Morrison Mayor APPROVED AS TO FORM: Claudia Gacitua Silva City Attorney SAN DIEGO SPORTS MEDICINE AND FAMILY HEALTH CENTER Dated: i By: Richard Parker, D.O., F.A.O.A.S.M. Wellness Director Dated: /°/L 3 1l Chief Financial Officer 2012 Agreement 14 Wellness Program Services SD Sports Medicine & Family Health Center City of National City and OFFICE OF THE CITY CLERK 1243 National City Blvd. National City, California 91950 Michael R. Dalla, CMC - City Clerk 619-336-4228 phone / 619-336-4229 fax November 5, 2012 Dr. Richard Parker San Diego Sports Medicine & Family Health Center 6699 Alvarado Road, Suite 101 San Diego, CA 92120 Dear Dr. Parker, On October 30`h, 2012, Resolution No. 2012-218 was passed and adopted by the City Council of the City of National City, authorizing execution of an Agreement with San Diego Sports Medicine & Family Health Center. We are enclosing for your records a certified copy of the above Resolution and a fully executed original Agreement. Sincerely, /ss�ay� Michael R. Dalla, CMC City Clerk Enclosures cc: Fire Dept.