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HomeMy WebLinkAbout25E - AGMT - OCCUPATIONAL MED SRVSREQUEST FOR COUNCIL ACTION CITY COUNCIL MEETING DATE: JANUARY 15, 2019 TITLE: APPROVE AN AGREEMENT WITH CONCENTRA MEDICAL CENTER DOING BUSINESS AS OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA (CONCENTRA), A MEDICAL CORPORATION TO PROVIDE OCCUPATIONAL MEDICAL SERVICES (STRATEGIC PLAN NO. 7,5) 7 RECOMMENDED ACTION CLERK OF COUNCIL USE ONLY: IT»iiP ❑ As Recommended ❑ As Amended ❑ Ordinance on 1" Reading ❑ Ordinance on 2n^ Reading ❑ Implementing Resolution ❑ Set Public Hearing For CONTINUED TO FILE NUMBER Authorize the City Manager and Clerk of the Council to execute an agreement with Concentra Medical Center doing business as Occupational Health Centers of California (Concentra), a Medical Corporation, to provide a comprehensive medical services review program for a three- year period from February 1, 2019 until January 31, 2022, and with two (2) one-year optional renewals of $100,000 each additional year not to exceed $500,000 over a five (5) year period. Subject to non -substantive changes approved by the City Manager and City Attorney. DISCUSSION It has been several years since the City has reviewed its current processes regarding employee medical examinations. To ensure these services are addressed effectively and timely, a Request for Proposals (RFP) for occupational health services was posted on August 27, 2018 (Exhibit 1). The purpose of the RFP was to identify qualified occupational health providers to perform the following scope of work: ■ Effectively coordinate, schedule and evaluate the results of a variety of medical examinations for City employees, including: ■ Pre-employment medical examinations and screenings; ■ Post -exposure medical examinations and screenings; ■ Fitness for duty examinations; • Department of Motor Vehicles (DMV) Commercial Classification Drivers License physical examinations; • Department of Transportation (DOT) -related drug and alcohol examinations and screenings; and ■ California OSHA (Occupational Safety and Health Act) occupational testing such as periodic evaluation of respiratory, audio and chest functions, as well as Hepatitis vaccinations and boosters, as needed. 25E-1 Agreement with Occupational Health Centers of California, a Medical Corporation January 15, 2019 Page 3 FISCAL IMPACT The agreement is for three (3) years from February 1, 2019 to January 31, 2022, for an estimated cost of $300,000 for the term of the agreement, with an option to extend twice, by mutual agreement of the Parties, for a period up to two (2) additional years. If an extension is recommended, it will be brought back to City Council for additional approval at that time. The City may terminate this agreement at any time, without cause, with thirty (30) days written notice. Funding for the proposed agreement is budgeted and available in the various departmental Contractual Services — Professional account (no. 62300). Human Resources Department APPROVED AS TO FUNDS AND ACCOUNTS: Kathryn Downs Executive Director'Sy� Finance and Management Services Agency Exhibits: 1. RFP for Occupational Medical Services and Review 18-073 2. Concentra Agreement 25E-2 Fiscal Year - Three Year Agreement Estimated Total Amount FY 2018-2019 (February — June) $ 50,000 FY 2019-2020 (12 months) $ 100,000 FY 2020-2021 (12 months) $ 100,000 FY 2021-2022 (6 months) $ 50,000 Two Year Renewal Option FY 2021-2022 (6 months) $ 50,000 FY 2022-2023 (12 months) $ 100,000 FY 2023- 024 (July - January) $ 50,000 Human Resources Department APPROVED AS TO FUNDS AND ACCOUNTS: Kathryn Downs Executive Director'Sy� Finance and Management Services Agency Exhibits: 1. RFP for Occupational Medical Services and Review 18-073 2. Concentra Agreement 25E-2 Agreement with Occupational Health Centers of California, a Medical Corporation January 15, 2019 Page 2 Additionally, as part of effective medical services review program management, the Consultant shall: • Maintain a network of qualified and trained medical providers and medical specialists for necessary exams; • Orient City staff in the legal/medical/risk management and human resources aspects of Consultant services; ■ Communicate directly with applicants to obtain confidential medical information that is needed for clearance for a particular job; ■ Conduct further investigation of medical conditions as identified during these exams; ■ Schedule, coordinate and maintain immunization records for current employees; ■ Provide written reports for each review undertaken for each applicant; ■ Facilitate additional reviews for applicants with medical or physical conditions requiring further testing or submission of additional information; ■ Manage all bill review functions for the medical exams performed by clinics; and, • Provide City staff access to Consultant's tracking system. Four proposals were received and evaluated based on the vendors' qualifications and experience, demonstrated knowledge of a variety of medical services, ability to fulfill scope of work, availability and convenience of services, cost competitiveness and responsiveness to the proposal. Following extensive evaluation of the proposals, the top three occupational health providers were invited to participate in an interview process. The panel was comprised of the Assistant Director of Human Resources, Interim Risk Manager and four Senior Human Resources Analysts. The panel members selected Concentra as the City's occupational health provider. Concentra has been known to deliver convenient and accessible medical services for its clients. They are considered the largest provider of occupational health services in the country. Concentra has over 530 medical centers across the Unites States with four convenient locations in Santa Ana. Concentra Medical Centers has demonstrated the requisite experience the City seeks, and currently provides occupational health services to many large and small employers, including the County of Orange, City of Lynwood, and City of Compton. Approval of this recommended action will allow the City's Human Resources Department to implement a comprehensive medical services review program with Concentra that will streamline and expedite the various medical processes required of our employees (Exhibit 2). STRATEGIC PLAN ALIGNMENT Approval of this item supports the City's efforts to meet Goal #7 Team Santa Ana, Objective #5 (Create a culture of innovation and efficiency within the organization), Strategy E (Identify best practices and opportunities for process improvement and automation across City departments in order to provide effective and efficient delivery of City services to the community). 25E-3 25E-4 REQUEST FOR PROPOSALS (RFP) TOB Occupational Medical Services and Review CITY OF SANTA ANA Human Resources Department P.O. Box 1988 20 Civic Center Plaza, M-24 Santa Ana, CA 92702-1988 Tania Knauerhaze Project Manager (714)647-5371 Office (714) 647-6930 Fax tknauerhaze(&santa-ana.org KEY RFP DATES: Issue Date: August 27, 2018 Questions Regarding Proposal Due via E-mail: September 10, 2018 Proposal Due Date: September 26, 2018 Presentation/Interviews: October 1 through October 9, 2018 Projected Award Date: November 21, 2018 During the Proposal period, all questions must be in writing and emailed to tknauerhaze@santa-ana.org, no later than September 10, 2018 at 5:00 p.m. The City will make every effort to respond to questions promptly. In addition, all submitted questions and responses will be consolidated and posted by September 19, 2018. EXHIBIT 1 City of Santa Ana Human Resources Department RFP for Medical Services Review—January 12, 2015 2`8E1-5 NOTICE INVITING PROPOSALS NOTICE IS HEREBY GIVEN that proposals will be received from qualified firms to provide a comprehensive Medical Services Review program for the City of Santa Ana. Responses to the Request for Proposals (RFP) will be accepted until September 26, 2018 at 5:00 p.m. If further information is required, contact Tania Knauerhaze at (714) 647-5371 or via e-mail at tknauerhaze(c)santa-ana.org. All notifications, updates and addenda will be posted on the City's current RFP Bid page at www.santa- ana.orq/finance/vendor registration.aso Proposers shall be responsible for monitoring the site to obtain information regarding this solicitation. Failure to respond to required updates may result in a determination of a nonresponsive proposal. MAILED, DELIVERED BY HAND, or COURIERED proposals will be accepted as follows: City of Santa Ana Attention: Tania Knauerhaze, Sr. Human Resources Analyst Human Resources Department 5'h Floor, City Hall P.O. Box 1988 20 Civic Center Plaza, M-24 Santa Ana, CA 92702-1988 It is the responsibility of the Proposer to ensure that any proposals submitted shall have sufficient time to be received by the City of Santa Ana prior to the proposal due date and time. Questions regarding this RFP shall be made in writing via e-mail to tknauerhaze(@santa-ana.orq by 5:00 p.m., September 10, 2018. The time actually received in the Human Resources Department, 20 Civic Center Plaza, Santa Ana, CA 92702 Fifth Floor, City Hall, will be the governing time for acceptability of proposals. Late proposals will NOT be considered and will be returned to Proposer unopened. Telegraphic, electronic, and facsimile proposals will NOT be accepted. ONLY SEALED RFP RESPONSES ARE ACCEPTABLE. DO NOT E-MAIL RFP RESPONSES. DO NOT FAX RFP RESPONSES. City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 2P6r= 6 CITY OF SANTA ANA — HUMAN RESOURCES DEPARTMENT RFP FOR MEDICAL SERVICES REVIEW TABLE OF CONTENTS I I. INTRODUCTION II. TERM OF CONTRACT/AGREEMENT III. OPTION OF RENEWAL IV. FISCAL NONFUNDING CLAUSE V. SCOPE OF SERVICES VI. GENERAL INFORMATION VII. CONSULTANT RESPONSIBILITIES VIII. IMPLEMENTATIONITRANSITION MEETINGS IX. CITY BUSINESS LICENSE REQUIREMENT X. ADDENDA XI. RULES FOR PROPOSALS XII. E-MAIL COMMUNICATIONS AND INTERPRETATIONS/CLARIFICATIONS XIII. SUBMITTAL INFORMATION AND DEADLINE XIV. SUBMITTAL REQUIREMENTS XV. CONSULTANT SELECTION — PROPOSAL AND EVALUATION XVI. PUBLIC RECORDS XVII. ERRORS AND OMISSIONS XVIII. FILING OF PROTESTS EXHIBIT A — SCOPE OF SERVICES 1. DESCRIPTION AND SCOPE OF SERVICE A. IMPLEMENTATION EXHIBIT B — SAMPLE AGREEMENT EXHIBIT C — PROPOSERS' CERTIFICATION AND PROPOSAL ITEM PRICING EXHIBIT D — PROPOSERS' REFERENCES EXHIBIT E — PROPOSER'S STATEMENT EXHIBIT F — CERTIFICATION OF NONDISCRIMINATION BY CONSULTANT EXHIBIT G — RESPONSIBLE PROPOSER — SUPPLEMENTAL QUESTIONNAIRE EXHIBIT H — NON -COLLUSION AFFIDAVIT EXHIBIT I — SAMPLE ADDITIONAL INSURED ENDORSEMENT City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 28E37 INTRODUCTION The City of Santa Ana is issuing this RFP for a Medical Services Review program. The City desires to implement a fully comprehensive and legally -defensible medical services review program as an essential part of the City's objective to provide and maintain a qualified work force. The City of Santa Ana, hereinafter referred to as "the City', is located in the County of Orange in Southern California. The City land area is 27.2 square miles and the population is approximately 334,000 people. The City employs approximately 1,000 full-time and 500 part-time employees in a wide variety of professions. City employees work within the following 10 departments: City Attorney, City Manager, Clerk of the Council, Community Development, Finance, Planning and Building, Parks and Recreation, Human Resources, Public Works, and Police. The City is soliciting proposals from qualified medical services review providers (`Proposers" or "Consultants") having special skill, knowledge and expertise in the field of impartial medical evaluations to: ➢ effectively coordinate, schedule and evaluate the results of a variety of medical examinations including: • pre-employment medical examinations and screenings; • post -exposure medical examinations and screenings; • fitness for duty examinations; • Department of Motor Vehicles (DMV) Commercial Classification Driver's License physical examinations; • certain Department of Transportation (DOT) -related drug and alcohol examinations and screenings; and • California OSHA (Occupational Safety and Health Act) occupational testing such as periodic evaluation of respiratory, audio, and chest functions, as well as Hepatitis vaccinations and boosters, as needed. ➢ objectively discern if potential applicants or current employees are able to perform the essential functions of the jobs for which they are being considered; and ➢ objectively discern if current employees are medically fit to return to their regular essential functions following events such as serious injuries, exposure, or long-term illnesses. The full Scope of Services is outlined in Exhibit A. Consultant will ensure clinics and laboratories used are qualified to perform DOT and non -DOT urine collection and breathalyzer testing, laboratory analysis and Medical Review Officer (MRO) responsibilities. The proposal shall be concise, to the point, and sufficient enough to coverall required submittals and exclude any extraneous materials. A cover letter shall summarize key factors and guarantee that key personnel will be committed to performing the required tasks throughout the duration of the contract. for Medical Services Review — August 27, 2018 f 8 II. TERM OF AGREEMENT Unless earlier terminated as allowed for in the Agreement, contract term shall be for a period of three (3) years. The contract term is anticipated to commence on November 21, 2018 contingent upon City Council award of this contract and upon receipt and approval of all required bonds and relevant iinsurance documents. III. OPTION OF RENEWAL The Agreement may be renewed up to two (2) times,ifor an additional one-year period each time, lupon the written agreement of both the Consultant and the City. Provisions for Agreement renewal are set forth in Exhibit B — Sample Agreement. IV. FISCAL NONFUNDING CLAUSE In the event sufficient budgeted funds are not available for a new fiscal period, the City shall retain the right to notify the provider of such occurrence in writing at least thirty (30) days before the end of the current fiscal period and terminate the agreement on the last day of the current fiscal period without penalty or expense to the City. V. SCOPE OF SERVICES The scope of services shall include any and all work efforts related to medical services review as set forth in Exhibit A — Scope of Services. Consultant shall be an independent contractor capable of providing experienced, knowledgeable, licensed and professional staff. Consultant shall be responsive and maintain excellent working relationships with City residents, businesses, government officials and City staff. Consultant shall provide adequate staffing levels at all times and adhere to established schedules. Consultant shall comply with all federal, state and local laws, rules, regulations, ordinances, and statutes, including but not limited to the Americans with Disabilities Act (ADA), the Health Insurance Portability and Accountability Act (HIPAA), the Federal Motor Carrier Safety Administration (FMCSA) rules and regulations, the U.S. Department of Transportation (DOT) rules and regulations, and the California Public Records Act (Cal. Govt. Code Sections 6250 et seq.). VI. GENERAL INFORMATION A. When determined appropriate, the City will provide information in its possession relevant to preparation of required information in the Request for Proposal. The City will provide only the staff assistance and documentation specifically referred to herein. B. The Proposer shall be responsible for retaining data, records and documentation for the preparation of the required information. These materials shall be made available to the City as requested by the City. C. This RFP does not commit the City to pay costs incurred in preparation of a response to this RFP. All costs incurred in the preparation of the proposal, the submission of additional information, attendance at pre -proposal conference, negotiations with City, and/or any other aspect of a proposal prior to award of a written contract will be borne by the Proposer. The City reserves the right to accept or reject the combined or separate components of this proposal in part or in its entirety or to waive any informality or technical defect in the proposal. for Medical Services Review — August 27, 2018 ZW 9 D. Nothing contained in this RFP shall create any contractual relationship between the Proposer and the City. E. All data, documents and other products used, developed, or produced during response preparation of the RFP will become property of the City. All responses to the RFP shall become property of the City. Proposer information identified as proprietary information shall be maintained confidential, to the extent allowed under the California Public Records Act. F. The City reserves the right to reject, replace and approve any and all subcontractors. All subcontractor(s) shall be identified in the response to the RFP and the City reserves the right to reject any subcontractor(s). Subcontractors shall be the responsibility of the prime contractor and the City shall assume no liability of such subcontractors. VII. CONSULTANT RESPONSIBILITIES The selected Proposer will assume responsibilities for all services in its proposal. The selected Proposer shall identify a sole point of contact with the greatest knowledge in regard to the required service operations and contractual matters, including payment of any and all charges resulting from the Agreement. VIII. IMPLEMENTATION/TRANSITION MEETINGS The successful Proposer will be required to meet with City staff prior to commencement of services or at any time as required by the City, to discuss and agree on operational issues including transition of services, training and scheduling. IX. CITY BUSINESS LICENSE REQUIREMENT The selected Proposer shall be required to obtain a City of Santa Ana Business license within thirty (30) days of selection, and must provide a copy to the City Projects Manager or designee prior to commencing any work in Santa Ana. X. ADDENDA Any subsequent changes in RFP from the date of preparation to date of submittal will result in an addendum or amendment by the issuing office. Notification of such addendum or amendment shall be effected by posting on City's website, as set forth in the Notice Inviting Proposals (see page two [2] of this RFP). XI. RULES FOR PROPOSALS The signer of the RFP must declare in writing that the only person, persons, company, or parties interested in the proposal as principals are named therein; that the proposal is made without collusion with any other person, persons, company, or parties submitting a proposal; that it is in all respects fair and in good faith without collusion or fraud, and that the signer of the proposal has full authority to bind the Proposer. Refer to Exhibit H — Non Collusion Affidavit. XII. E-MAIL COMMUNICATIONS AND INTERPRETATIONS/CLARIFICATIONS To facilitate the RFP process, Proposers are required to monitor the City's Bid and RFP page at www.santa-ana.org/finance/vendor registration. asp No oral interpretations will be made by the City to any Proposer as to the meaning of requirements identified herein, including the Scope of Services and Terms and Conditions. Every request for such an interpretation must be made in writing via a - ( of Santa Ana Human Resources Department for Medical Services Review—August 27, 2018 2610 mail to the projects manager no fewer than five (5) calendar days prior to the proposal due date. Significant interpretations or clarification will be made by an addendum to this RFP, which will be posted to the website. Addenda may become part of the agreement documents. XIII. SUBMITTAL INFORMATION AND DEADLINE Proposals are due tb the City of Santa Ana, at the date, time, and location set forth on the Notice Inviting Proposals. Faxed and e-mail proposals will not be accepted. XIV. SUBMITTAL REQUIREMENTS i The RFP is intended to assess and evaluate each firm's capabilities as they apply to the proposed services. Submittal of Proposal A. Four (4) hard .copies of the response to the RFP shall be signed by a company official with the power to bind the company. B. One (1) copy of the submittal on a USB flash drive or equivalent. C. Proposals should be structured to include the Scope of Services response, general time implementation schedule, fees/contract price, and exhibits. All Proposers must address each of the following items in their response to the RFP: A. Statement of Qualifications In order to maintain uniformity, the Statement of Qualifications must be limited to a MAXIMUM OF TWENTY (20) PAGES (excluding front and back covers, section dividers and exhibits). The page limitation includes all appendices, attachments, and supplemental information. The following information is required: Cover Letter Provide a letter signed by a principal or authorized representative who can make legally binding commitments for the entity. Organization and Credentials The name, address and telephone number of the person to whom correspondence should be directed and who has authority to negotiate on behalf of the firm. Provide a synopsis of the consultant's qualifications and past experience in medical services review programs. Proiect Approach Provide an outline expressing the Consultant's understanding of the project and summarizing the basic approach to providing medical services review. Additionally, outline how Consultant meets the requirements of a DOT -compliant testing program. ImplementationMork Plan Provide a detailed description of how your organization intends to provide the services outlined in this RFP. The descriptions should be formatted to enable the City to evaluate the Consultant's capability to effectively coordinate and manage medical services review. Consultant is free to comment on any other medical services review -related activities or initiatives your organization would recommend and assist in implementing. City of Santa Ana Human Resources Department RFP for Medical Services Review—August 27, 2018 20GE-e-711 Proposal should include general information on procedures followed regarding notification to City for all medical services provided. Proposal should include information on Consultant's recordkeeping protocols. Experience of Proposer Describe and provide examples of a minimum of 3 similar medical services review programs you have managed for agencies similar in size to the City oflSanta Ana. Experience pertaining to public agencies is preferred. Staffing Proposer shall identify their Project Manager assigned to thle project, who shall be committed to this project for a minimum of one (1) full year. Proposer shall also identify other key personnel, their qualifications, education, representative experience, and their capability to explore and resolve problems. Proposer shall provide their availability for site meetings and local training. Include the name of the employee/agent/associate in charge of the medical services review program when project manager is unavailable. Please provide an organization chart identifying those personnel who will perform services for this project. Once the agreement is executed, key members of the Proposer's staff shall not be substituted without the prior written approval of the City of Santa Ana. Sub -consultants The Consultant shall identify any sub -consultants it intends to employ in relation to this agreement. The Consultant shall identify sub -consultants' qualifications and key personnel. The Consultant shall be held responsible for any and all work performed by the Consultant's sub-consultant(s). List the estimated percentage of work each sub -consultant will perform for each of the tasks. Physicians and Clinics Used by Consultant Consultant shall ensure all physicians, clinics and other medical facilities used by Consultant possess and maintain all appropriate licenses and insurance as specified by the City. Consultant shall ensure all physicians, laboratory technicians, collectors, clinics and other medical facilities and staff used in conjunction with DOT -related drug and alcohol testing follow and are in compliance with DOT testing procedures as per 49 CFR, Part 40. B. EXHIBIT C — PROPOSERS FEE STATEMENT AND PROPOSAL ITEM PRICING The proposal shall include a fee schedule for the services to be performed, which shall be based on the Consultant's best pricing. C. EXHIBIT D — REFERENCES The proposal shall include a list of agencies, past and present, for which you have provided work similar to that identified in the Scope of Services (Exhibit A) for the last three (3) years. D. EXHIBIT E — PROPOSER'S STATEMENT The Proposer shall submit a signed statement that Proposer understands that a proposal is required for the entire work, that the estimated quantities set forth in the RFP schedule are solely for the purpose of comparing proposals, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. Proposer shall acknowledge that all terms contained in the specifications, the certification of nondiscrimination by contractors, and the required insurance certificates are to be incorporated by reference into this agreement and are made specifically as part of this RFP. i of Santa Ana Human Resources Department for Medical Services Review—August 27, 2018 2-8 12 E. EXHIBIT F — CERTIFICATION OF NONDISCRIMINATION BY PROPOSER The Proposer shall submit a statement that it does not discriminate in its employment actions or services rendered, as per California and Federal law. F. EXHIBIT G — RESPONSIBLE PROPOSER — SUPPLtMtN IAL Wit, The Proposer'shall submit a detailed SAF with all questions answered. . G. EXHIBIT H — NONCOLLUSION AFFIDAVIT i The Proposer shall submit a statement whereby Proposer declares .that the proposal is not made in the interest of, or on behalf of, any undisclosed person,j partnership, company, association, organization, or corporation; and that the proposal is genuine and not collusive or sham. H. EXHIBIT I — Proposer shall submit an additional insured endorsement as per Exhibit I. i The proposal must be completely responsive to the RFP. Any exceptions to the requirements of this RFP must be included in the proposal. Such exceptions must be included as a separate element of the proposal entitled "Exceptions and Deviations." The Executive Director of Human Resources, in his sole and absolute discretion, may authorize or deny any exceptions. J. The City reserves the right to reject any or all proposals submitted and no representation is made hereby that any contract will be awarded pursuant to this RFP or otherwise. The City reserves the right to waive minor inconsistencies in submitted Proposals. XV. CONSULTANT SELECTION — PROPOSAL AND EVALUATION Proposal should be straightforward, concise and provide "layman" explanations of technical terms that are used. Emphasis should be concentrated on conforming to the RFP instructions, responding to the RFP requirements, and on providing a complete and clear description of the offer. Proposals which appear unrealistic in terms of technical commitments, lack of technical competence or are indicative of failure to comprehend the complexity and risk of this agreement may be rejected. The response to this RFP for Medical Services Review program should contain documentation of consultants and/or consultant's Department's credentials and expertise. Substantial consideration will be given to Consultants with demonstrable and documented experience in similar work. Responses will be evaluated on the following basis: 25% Qualifications and Experience 25% Understanding of Scope of Work 25% Demonstrated Knowledge of Medical Services Review program management 10% Cost competitiveness 10% Staff Availability 5% Responsiveness of the Proposing Firms and Fee Schedules The responses received will be reviewed by an evaluation committee appointed by the Executive f of Santa Ana Human Resources Department for Medical Services Review — August 27, 2018 26E=l 3 Director of the Human Resources Department. All proposals received will be fully reviewed and rated by the Evaluation Committee. The committee will evaluate proposals based on the response to the RFP and the evaluation criteria set forth above. A final score will be calculated for each submitted proposal and used to rank the Proposers. The committee may interview the top tier of Proposers and recommend award of the agreement to the Proposer who will provide the best quality service at minimum cost to the City. The City reserves the right to negotiate pricing and for additional terms. City reserves the right to begin negotiations and enter into an agreement without interview or further discussions. XVI. PUBLIC RECORDS Proposals will become public record after award of an agreement. Proposer information identified as proprietary information shall be maintained confidential, to the extent allowed under the California Public Records Act. XVII. ERRORS AND OMISSIONS Proposer shall not be allowed to take advantage of any errors in or omissions from the Request for Proposals. Full instructions shall be given if any such error or omission is discovered and timely called to the attention of the City. XVIII. FILING OF PROTESTS Proposers may file a bid "protest" with the City's Purchasing Department. In order for a Proposer's protest to be considered valid, the protest must: A. Be filed in writing within five (5) business days after the proposal issue date or before 5:00 p.m. of the 51' business day following the posting of Laid Results/Notice of Intent to Award Contract on the City's website; B. Clearly identify the specific irregularity or accusation; C. Clearly identify the specific City staff determination or recommendation being protested; D. Specify, in detail, the grounds of the protest and the facts supporting the protest; and E. Include all relevant, supporting documentation with the protest at time of filing. If the protest does not comply with each of these requirements, it will be rejected as invalid. If the protest is valid, the City's Purchasing Manager, or other designated City staff member, shall review the basis of the protest and all relevant information. The Purchasing Manager will provide a written decision to the protestor within fourteen (14) calendar days. City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 2tr'4 4 EXHIBIT A CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM SCOP OF SERVICES DESCRIPTION AND SCOPE OF SERVICES j The City of Santa Ana.is issuing this Request for Proposals (RFP) for a medical services review program; such program to include organizing, scheduling, managing, and/or evaluating a comprehensive range of medical services and examinations, including but not limited to: a) For prospective and current City employees to perform the duties of the position for which they are being considered (pre-employment assessments), using pre -determined medical protocols for each job classification such protocols may be modified by the physician, in consultation with the City's Executive Director of the Human Resources Department, or his/her designee, as is necessary to make a determination as to suitability for employment; b) For current City employees being considered for employment in Department of Transportation (DOT) and non -DOT positions requiring pre -placement or pre -assignment drug screens; c) Fitness for Duty examinations (industrial and non -industrial), and provide reports and recommendations regarding the suitability of current employees to continue to perform their duties; d) Urine and breath specimen collection, laboratory analysis and Medical Review Officer (MRO) responsibilities; e) Department of Motor Vehicles (DMV) Driver's License physical examinations; f) DOT -mandated drug and alcohol testing of employees considered 'safety sensitive' as defined under DOT regulations and City policy. Consultant shall ensure all such testing complies with DOT testing procedures as per 49 CFR, Part 40; such testing to include pre-employment and pre -assignment. City shall be responsible for the organization, scheduling, and management of DOT and non -DOT random and reasonable suspicion drug and alcohol testing, and DOT post -accident drug and alcohol testing. Consultant shall evaluate results of said testing, in accordance with the provisions of the Agreement and relevant laws and regulations. Consultant shall ensure clinic(s) used for DOT -related drug and alcohol testing maintains a current valid contract with a Substance Abuse and Mental Health Services Administration (SAMSHA)-certified laboratory that is agreed upon with the City of Santa Executive Director of Human Resources. Consultant shall ensure turn -around time from specimen collection to obtained test results shall be a maximum of three (3) working days for a negative test, and a maximum of five (5) working days for a positive test. As part of the medical services review program, Consultant shall: 1) Analyze current job classification specifications and make recommendations for the City's use in the pre- employment medical examination and drug testing process, random drug screen inclusion for safety sensitive positions inclusive of DOJ regulations, and occupational injury medical examination for return- to-work/fitness for duty. 2) Provide training to Human Resources personnel in administration procedures of Consultant's medical services review process. 3) Communicate with City Human Resources staff regarding applicants' or employees' progress throughout the medical services review process. 4) Communicate directly with applicants and City Human Resources staff throughout the pre-employment or pre -assignment process in regard to results and medical conditions as ascertained through the medical or physical examinations. 5) Provide an electronic final report in a format established by City Human Resources staff at its sole City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 25&'15 discretion, outlining each candidate's pre-employment placement medical evaluation and results. a. Submit an example of a current report that your organization utilizes. 6) Provide quarterly electronic activity reports, in a format established by Human Resources in its sole discretion, on the nature and number of examinations conducted, including but not limited to results and final dispositions. 7) Provide a detailed quarterly explanation and summary of charges incurred. 8) Provide all quarterly and annual summaries as required under the DOT; 9) Provide consultation as needed to, Human Resources staff regarding medical services provided and outlined in the Agreement. 10) Consultant solely shall review all I pre-employment/pre-placement medical evaluation services and maintain records, pursuant to the Agreement, in accordance with State and Federal laws, or as otherwise reasonably required by the City, and to the fullest extent permitted by law. 11) Consultant agrees to permit duly -authorized agents and employees of the City to review such records. 12) Consultant shall maintain all books, documents, papers, accounting records, and other evidence pertaining to the fee paid under this Agreement. Consultant will make materials available at their offices at reasonable times and notice, during the period of the Agreement and for three (3) years after date of final payment under the Agreement for inspection by the City or by any other governmental entity or Department participating in the funding of the Agreement, or any authorized agents thereof: 13) Consultant's documents shall not be used, duplicated, or disclosed to any other third party without written permission, unless such disclosure is required by law. Consultant shall not be required to create or maintain books and records not required in the ordinary course of Consultant's business operations, nor will the Consultant be required to disclose any information, including but not limited to product cost or pricing data, which Consultant considers confidential or proprietary. 14)Any Agreement changes which are mutually agreed upon by and between the parties shall be incorporated in written amendments to the Agreement. 15) If the circumstances on a particular hearing and/or court proceeding warrant the presence of a competent and knowledgeable representative of the Consultant, in the sole discretion of the City, City will request and contractor shall provide such representative, at no additional cost to City. Additionally, as part of the medical services review program, Consultant shall: o Maintain a network of qualified and trained medical providers and medical specialists for necessary exams; o Orient City staff in the legal/medical/risk management and human resources aspects of Consultant services; o Communicate directly with applicants to obtain the confidential medical information that is needed for clearance for a particular job; o Manage all bill review functions for the medical exams performed by clinics; and, o Provide access for City staff to Consultant's tracking system. Depending on job classification, pre-employment and pre -assignment medical examination processes may include; job profile review; review of medical history; check vital signs; detailed vision exam, including check of near/far/peripheral vision, Ishihara 14 and primary color; audiogram (if classification has specific occupational noise exposure or critical hearing demands); chest x-ray; EKG or treadmill stress EKG; Spirometry; chem panel 20; CBC w/diff; dipstick UA, or UA w/Micro (to lab); venipuncture & collection. Individual medical exams, such as post exposure, fit for duty, or others, may include one or more of the following: o Audiogram o Back X-ray o Blood Lead Level ZZP o Blood screens — 7 panel drug screen City of Santa Ana Human Resources Department RFP for Medical Services Review—August 27, 2018 2tr=1-'16 A. o Blood chemistry profile (SMA 24 or equivalent) o Complete blood count (CBC w/diff) o Chest X-ray o DMV Physicals o Electrocardiogram o Hepatitis "A" blood screen i o Hepatitis "B" blood screen o Hepatitis "B" booster j o Hepatitis "B" titer o Hepatitis "B" Vaccine o Hepatitis "A" Vaccine i o Hepatitis "C" blood screen o HIV blood screen o Pulmonary function test o Respirator Fit test o Respirator Physical o Respirator Questionnaire if PX is not required with;clearance o TB test o Urinalysis: Urinalysis with microscopy (UA w/micro) Urinalysis with dipstick (Dipstick UA) IMPLEMENTATION Upon award of the contract/agreement, City shall work with Consultant to develop effective implementation protocols to ensure contract implementation shall commence on November 21, 2018. for Medical Services Review—August 27, 2018 2REA 7 EXHIBIT B CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM SAMPLE AGREEMENT THIS AGREEMENT, made and entered into this day of 2018 by and between NAME, a professional corporation (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). 1 1 RECITALS A. The City desires to retain a medical consultant having special skill, knowledge and expertise in the field of medical services to provide a fully comprehensive and legally -defensible medical services review program as an essential part of the City's objective to provide and maintain a qualified work force. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: SCOPE OF SERVICES Consultant shall organize, schedule, manage, and/or evaluate a comprehensive range of medical services and examinations, including but not limited to: A. For prospective and current City employees to perform the duties of the position for which they are being considered (pre-employment assessments), using pre -determined medical protocols for each job classification; such protocols may be modified by the physician, in consultation with the City's Executive Director of the Human Resources Department, or his/her designee, as is necessary to make a determination as to suitability for employment; B. For current City employees being considered for employment in Department of Transportation (DOT) and non -DOT positions requiring pre -placement or pre -assignment drug screens; C. Return -to -work and Fitness for Duty examinations (industrial and non -industrial), and provide reports and recommendations regarding the suitability of current employees to continue to perform their duties; D. Urine and breath specimen collection, appropriate chain of custody protocol, laboratory analysis and Medical Review Officer (MRO) responsibilities; E. Department of Motor Vehicles (DMV) Commercial Classification Driver's License physical examinations; F. DOT -mandated drug and alcohol testing of employees considered 'safety sensitive' as defined under DOT regulations and City policy. Consultant shall ensure all such testing complies with DOT testing procedures as per 49 CFR, Part 40; such testing to include pre-employment, pre -assignment and random screening. City shall be responsible for the organization, scheduling, and management of DOT and non -DOT "reasonable City of Santa Ana Human Resources Department RFP for Medical Services Review—August 27, 2018 2'8E118 suspicion" drug and alcohol testing, and DOT "random" and "post -accident" drug and alcohol testing. Consultant shall facilitate evaluation of the results of said testing by qualified personnel, in accordance with the provisions of the Agreement and relevant laws and regulations. Consultant shall ensure clinics used for DOT -related drug and alcohol testing maintain a current valid contract with a Substance Abuse and Mental Health Services Administration (SAMSHA)-certified laboratory. Consultant shall ensure turn -around time from specimen collection to obtained test results shall be a maximum of three (3) working days for a negative test, and a maximum of five (5) working days for a positive test. As part of the medical services review program, Consultant shall: 1) Analyze current job, classification specifications and make recommendations for the City's use in the medical examination and drug testing process. 2) Provide training to Human Resources personnel in administration procedures of Consultant's medical services review process. 3) Communicate with City Human Resources staff regarding applicants' or employees' progress throughout the medical services review process. 4) Communicate directly with applicants and City Human Resources staff throughout the pre- employment or pre -assignment process regarding results and medical conditions as ascertained through the medical or physical examinations. 5) Provide an electroriic final report in a format established by City Human Resources staff at its sole discretion, outlining' each candidate's pre-employment placement medical evaluation and results. 6) Provide quarterly electronic activity reports, in a format established by Human Resources in its sole discretion, on the nature and number of examinations conducted, including but not limited to results and final dispositions. 7) Provide a detailed quarterly explanation and summary of charges incurred. 8) Provide all quarterly and annual summaries as required under the DOT; 9) Provide consultation as needed to Human Resources staff regarding medical services provided and outlined in the Agreement. 10) Consultant solely shall review all pre-employment/pre-placement medical evaluation services and maintain records, pursuant to the Agreement, in accordance with State and Federal laws, or as otherwise reasonably required by the City, and to the fullest extent permitted by law. 11) Consultant agrees to permit duly -authorized agents and employees of the City to review such records. 12) Consultant shall maintain all books, documents, papers, accounting records, and other evidence pertaining to the fees paid under this Agreement. Consultant will make materials available at their offices at reasonable times and notice, during the period of the Agreement and for three (3) years after date of final payment under the Agreement for inspection by the City or by any other governmental entity or Department participating in the funding of the Agreement, or any authorized agents thereof. 13) Consultant's documents shall not be used, duplicated, or disclosed to any other third party without written permission, unless such disclosure is required by law. Consultant shall not be required to create or maintain books and records not required in the ordinary course of Consultant's business operations, nor will the Consultant be required to disclose any information, including but not limited to product cost or pricing data, which Consultant considers confidential or proprietary. 14)Any Agreement changes which are mutually agreed upon by and between the parties shall be incorporated in written amendments to the Agreement. 15) If the circumstances on a particular hearing and/or court proceeding warrant the presence of a competent and knowledgeable representative of the Consultant, in the sole discretion of the City, City will request and contractor shall provide such representative, at no additional cost to City. Additionally, as part of the medical services review program, Consultant shall: o Maintain a network of qualified and trained medical providers and medical specialists for necessary exams; City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 29-9 o Orient City staff in the legal/medical/risk management and human resources aspects of Consultant services; o Communicate directly with applicants to obtain the confidential medical information that is needed for clearance for a particular job; o Manage all bill review functions for the medical exams performed by clinics; and, o Provide access for City staff to Consultant's tracking system Depending on job classification, pre-employment and pre -assignment medical examination processes may include: job profile review; review of medical history; check vital signs; detailed vision exam, including check of near/far/peripheral vision, Ishihara 14 and primary color; audiogram (if classification has specific occupational noise exposure or critical hearing demands); chest x-ray; EKG or treadmill stress EKG; Spirometry; chem panel 20; CBC w/diff; dipstick UA, or UA w/Micro (to lab); venipuncture & collection. Individual medical exams, such as post exposure, fit for duty, or other examinations, as needed, may include one or,more of the following: o Audiogram o Back X-ray o Blood Lead Level ZZP o Blood screens — 7 panel drug screen o Blood screens — 9 panel drug screen o Blood chemistry profile (SMA 24 or equivalent) o Complete blood count (CBC w/diff) o Chest X-ray o DMV Physicals o Electrocardiogram o Hepatitis "A" blood screen o Hepatitis "B" blood screen o Hepatitis "B" booster o Hepatitis "B" titer o Hepatitis "B" Vaccine o Hepatitis "A" Vaccine o Hepatitis "C" blood screen o HIV blood screen o Pulmonary function test o Respirator Fit test o Respirator Physical o Respirator Questionnaire if PX is not required with clearance o TB test o Urinalysis: • Urinalysis with microscopy (UA w/micro) • Urinalysis with dipstick (Dipstick UA) 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A, attached hereto and incorporated by this reference. The total annual sum to be expended under this Agreement is not anticipated to exceed $25,000.00. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. City of Santa Ana Human Resources Department RFP for Medical Services ieReview —August 27, 2018 Ar. 0 3. TERM This Agreement shall commence on November 21, 2018 and terminate on November 20, 2021, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of the Human Resources Department and !the City Attorney. i The Agreement may be renewed up to two (2) times, for an additional one-year period each time upon a writing executed by the City Manager, or his/her designee, and the City Attorney, or his/her designee. I 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer- employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which ;Consultant performs the services which are the subject; matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment'insurance and similar taxes relating to employees and 'shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. i. Consultant shall maintain commercial general liability insurance naming the City, its officers, agents, volunteers, and employees as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles. ii. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence. Consultant shall supply City with a fully executed additional insured endorsement in substantially the form attached hereto as Exhibit B upon execution of this Agreement and shall be approved in form by the City Attorney. b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. C. Errors and Omissions. Consultant shall maintain professional liability (errors and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. d. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: City of Santa Ana Human Resources Department RFP for Medical Services Review—August 27, 2018 29E=2 1 i. Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. ii. Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. iii. Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. I I e. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force i and paid for, the City shall have they right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives 'from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. CONFIDENTIALITY Consultant shall conform to all HIPAA requirements regarding examinations performed by Consultants. If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. 8. CONFLICT OF INTEREST CLAUSE of Santa Ana Human Resources Department for Medical Services Review—August 27, 2018 Arz1-12 Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shallj be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certifies] mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the Council City of Santa Ana 20 Civic Center Plaza, M-30 P.O. Box 1988 Santa Ana, CA 92702-1988 [Fax]: (714) 647-6956 i With courtesy copies to: Executive Director of the Human Resources Department City of Santa Ana 20 Civic Center Plaza, M-24 P.O. Box 1988 Santa Ana, CA 92701-1988 [Fax]: (714) 647-6930 and, City Attorney City of Santa Ana 20 Civic Center Plaza, M-29 P.O. Box 1988 Santa Ana, California 92702 [Fax]: (714) 647-6515 To Consultant CONSULTANT NAME ADDRESS CITY, STATE, ZIP CODE [Fax]: (714) A party may change its address by giving notice in writing to the other party. Thereafter, any notice, tender, demand, delivery, or other communication shall be addressed and transmitted to the new address. If sent by mail, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed asset forth above. If sent by fax, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and City of Santa Ana Human Resources Department RFP for Medical Services Review—August 27, 2018 2-23 supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, that terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on lbehalf of any party, which are not embodied herein. I 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. , 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex (including gender identity and gender expression), marital status, sexual orientation and genetic characteristics (including genetic tests of the individual or the individual's family, and manifestation of a disease or disorder in the individual's family members, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement and all questions relating to its validity, interpretation, performance, and enforcement shall be government and construed in accordance with the laws of the State of California. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES / or Santa Ana Human Kesources uepartment for Medical Services Review—August 27, 2018 216x= qt4 Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. j 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: MARIA D. HUIZAR Clerk of the Council APPROVED AS TO FORM: 0 SONIA R. CARVALHO City Attorney DED FOR APPROVAL: Steven V. Pham Executive Director— Human Resources Department CITY OF SANTA ANA RAUL GODINEZ II City Manager CONSULTANT CONSULTANT NAME Consultant's Title Individual SS # City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 2225 EXHIBIT C CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM PROPOSERS CERTIFICATION and PROPOSAL ITEM PRICING Certification - I certify that I have read, understand and agree to the terms and conditions of this Request for Proposals. I have examined the Scope of Services (Exhibit A) and am familiar with the scope of work locations. I am familiar withiall the existing conditions and limitation that may impact work requests. I understand and agree that I am responsible for reporting any errors, omissions or discrepancies to the City for clarification prior to the submission of my proposal. Proposal Item Price - Pricing shall be based on the services performed, for services described in Exhibit A. Fee must be inclusive of all costs, including but not limited to, direct and indirect costs for labor, overhead, incidental supplies, travel, mileage, and fuel. Attach additional pages as needed. ESTIMATED COST PER ESTIMATED. TYPE OF MEDICAL PROCEDURE # OF TESTS TEST TOTAL COST LEGAL NAME OF COMPANY PHONE AND FAX NUMBERS BUSINESS ADDRESS PRINTED NAME OF AUTHORIZED AGENT SIGNATURE OF AUTHORIZED AGENT FEDERAL ID NUMBER (IF APPLICABLE) DATE TITLE E-MAIL ADDRESS CONTRACTOR LICENSE NUMBER (IF APPLICABLE) THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. for Medical Services Review—August 27, 2018 2P tt6 EXHIBIT D CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM REFERENCES List and describe fully the contracts performed by your firm which demonstrate your ability to provide the supplies, equipment or services included in the scope of the proposal specifications. Attach additional pages if required. The City reserves the right to contact each of the references listed for additional information regarding your firm's qualifications. Reference Customer Address: Contract Amount: Description of supplies, equipment, or services provided: Reference Customer Address: Contact Individual: Phone Number: Facsimile Number: Year: Contact Individual: Phone Number: Facsimile Number: Contract Amount: Year: Description of supplies, equipment, or services provided: Reference Customer Address: Contract Amount: Description of supplies, equipment, or services provided: Contact Individual: Phone Number: Facsimile Number: Year: THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. City of Santa Ana Human Resources Department RFP for Medical ServiccessReview— August 27, 2018 267227 EXHIBIT E CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM PROPOSER'S STATEMENT Proposer understands and agrees that this written RFP (or any part thereof specifically designated and accepted by the City of Santa Ana, hereinafter City) shall constitute the entire agreement between Proposer and the City only after it!has been accepted by the City Council, endorsed by the Clerk of the Council with her signature and official seal noting hereon the action of approval of the Council, signed by the Executive Director or his duly authorized agent, and signed by the City Attorney, denoting his approval of the form of this document, and its execution, and when it or an exact copy of it has been either delivered to Proposer or deposited with the United States Postal Service properly addressed to the Proposer with the correct postage affixed thereto. Proposer further agrees that upon delivery (as defined above) of the accepted agreement he/she will furnish City all required bonds and certificate of liability insurance within ten (10) days (excluding Saturdays, Sundays and City's legal holidays), or the funds, check, draft, or Proposer's bond substituted in lieu thereof accompanying this proposal shall become the property of the City and shall be considered as payment of damages due to the delay and other causes suffered by City because of the failure to furnish the necessary bonds and because it is distinctly agreed that the proof of damages actually suffered by City is difficult to ascertain; otherwise said funds, check drafts, or Proposer's bond substituted in lieu thereof shall be returned to the undersigned. Proposer understands that a proposal is required for the entire work, that the estimated quantities set forth in the RFP schedule are solely for the purpose of comparing proposals, and that final compensation under the contract will be based upon the actual quantities of work satisfactorily completed. All terms contained in the specifications, the certification of nondiscrimination by contractors, and the required insurance certificates are to be incorporated by reference into this agreement and are made specifically as part of this RFP. Firm Signed and Printed Name: Title Date THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 2612-E '18 EXHIBIT F CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM I CERTIFICATION OF NONDISCRIMINATION BY CONSULTANT The undersigned Consultant or corporate officer, during the performance of this contract, certifies as follows 1. Consultant shall not discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. Consultant shall take affirmative action to ensure that applicants are employed, and that employees are treated during employment without, regard to their race, color, religion, sex, or national origin. Such action shall include, but not be limited to, the following: employment, upgrading, demotion, or transfer; recruitment or recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. Consultant agrees to post in conspicuous places, available to employees and applicants for employment, notices to be provided setting forth the provisions of this nondiscrimination clause. 2. Consultant shall state that, in all solicitations or advertisements for employees placed by or on behalf of Consultant, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, or national origin. 3. Consultant shall send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or understanding, a notice to be provided advising the said labor union or workers' representatives of Consultant's commitments under this section, and shall post copies of the notice in conspicuous places available to employees and applicants for employment. 4. Consultant shall comply with all provisions of Executive Order 11246 of September 24, 1965, and of the rules, regulations, and relevant orders of the Secretary of Labor. 5. Consultant shall furnish all information and reports required by Executive Order 11246 of September 24, 1965, and by rules, regulations, and orders of the Secretary of Labor, or pursuant thereto, and will permit access to his/her books, records, and accounts by the administering Department and the Secretary of Labor for purposes of investigation, to ascertain compliance with such rules, regulations, and orders. 6. In the event of Consultant's noncompliance with the nondiscrimination clauses of this contract or with any of the said rules, regulations, or orders, the contract may be canceled, terminated, or suspended in whole or in part and Consultant may be declared ineligible for further government contracts or federally assisted construction/services contracts in accordance with procedures authorized in Executive Order 11246 of September 24, 1965, and such other sanctions may be imposed and remedies invoked as provided in Executive Order 11246 of September 24, 1965, or by rule, regulations, or order of the Secretary of Labor, or as otherwise provided by law. 7. Consultant shall include the portion of the sentence immediately preceding paragraph 1 and the provisions of paragraphs 1 through 7 in every subcontract or purchase order unless exempted by rules, regulations, or orders of the Secretary of Labor issued pursuant to Section 204 of Executive Order 11246 of September 24, 1965, so that such provisions will be binding upon each subcontract or purchase order as the administering Department may direct as means of enforcing such provisions, including sanctions for noncompliance; provided, however, that in the event Consultant becomes involved in, or is threatened with, litigation by a sub Consultant or vendor as a result of such direction by the administering Department, Consultant may request that the United States enter into such litigation to protect the interests of the United States. City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 219 8. Pursuant to California Labor Code Section 1735, as added by Chapter 643 Stats. 1039, and as amended, no discrimination shall be made in the employment of persons because of race, religious creed, color national origin, ancestry, physical handicaps, mental condition, marital status, or sex of such persons, except as provided in Section 1420, and any Consultant violating this section is subject to all the penalties imposed for a violation of the chapter. i Firm Signed and Printed Title Date THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 Arz vi30 2. EXHIBIT G CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM I RESPONSIBLE PROPOSER — SUPPLEMENTAL QUESTIONNAIRE How many years has your organization been in business in California under your present business If you performed same business under a different business name with same ownership and operation management and changed name due to, but not limited to, bankruptcy, loss, or license, please complete an additional and separate questionnaire. Is your firm currently the debtor in a bankruptcy case? ❑Yes ❑No i If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. Case Number Bankruptcy Court Date Filed 3. Was your firm in bankruptcy any time during the last five years? (This question refers only to a bankruptcy action that was not described in answer to Question 2, above.) ❑Yes [:]No If "yes," indicate the case number, bankruptcy court, and the date on which the petition was filed. Case Number Bankruptcy Court Date Filed 4. Has any California State License Board license held by your firm or its responsiblemanaging employee or responsible managing officer been suspended within the last five years? ❑Yes ❑No 5. At any time in the last five years, has your firm been assessed and paid liquidated damages after completion of a medical services review program contract with either a public or private owner? Dyes ❑No Has your firm ever defaulted on a contract? ❑ Yes ❑ No If "yes, " explain on a separate page. 8. In the last five years has your firm, or any firm with which any of your company's owners, officers or partners was associated, been debarred, disqualified, removed, or otherwise prevented from bidding on, or completing, any government Department project for any reason? ❑ Yes ❑ No If "yes, " explain on a separate page. State the name of the organization debarred, the year of the event, the owner of the project, and the basis for the action. EXHIBIT G "RESPONSIBLE PROPOSER SAP' CONTINUES ON NEXT PAGE City of Santa Ana Human Resources Department RFP for Medical Services Review—August 27, 2018 26T231 9. In the past five years, has any claim against your firm concerning your firm's work on a medical services review program, been filed in court or arbitration? ❑ Yes ❑ No if "yes," on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution.) 10. In the past five years, has your firm made any claim against a government Department concerning services provided, and filed that claim in court or arbitration? ❑ Yes ❑ No If `yes,"on a separate page identify the claim(s) by providing the project name, date of the claim, name of the claimant, the name of the entity the claim was filed against, a brief description of the nature of the claim, the court and case number, and a brief description of the status of the claim (pending or, if resolved, a brief description of the resolution.) 11. At any time during the past five years, has any surety company made any payments on your firm's behalf as a result of a default, to satisfy any claims made against a performance or payment bond issued on your firm's behalf in connection with a project, either public or private? ❑ Yes ❑ No 12. In the last five years, has any insurance carrier, for any form of insurance, refused to renew the insurance policy for your firm? ❑ Yes ❑ No 13. Has your firm or any of its owners, officers, or partners ever been liable in a civil suit, or found guilty in a criminal action, for making any false claim or material misrepresentation to any public Department or entity? ❑ Yes ❑ No 14. Has your firm or any of its owners, officers or partners ever been convicted of a federal or state crime of fraud, theft, or any other act of dishonesty? ❑Yes ❑No If "yes," identify on a separate page, the person or persons convicted, the court case and number, the crimes and the year convicted. 15. During the last five years, has your firm ever been denied bond credit by a surety company, or has there ever been a period of time when your firm had no surety bond in place during a project when one was required? ❑ Yes ❑ No THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. i�:cirf��❑ of Santa Ana Human Resources Department for Medical Services Review—August 27, 2018 2tr=E32 CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM NON -COLLUSION AFFIDAVIT NON -CO II LUSION AFFIDAVIT (Title 23 United States Code Section 112 and Public Contract Code Section 7106) To the CITY OF SANTA ANA In accordance with Title 23 United States Code. Section 112 and Public Contract Code 7106 the Proposer declares that the proposal is not made in the interest of, or on behalf of, any undisclosed person, partnership, company, association, organization, or corporation; that the proposal is genuine and not collusive or sham; that the Proposer has not directly or indirectly induced or solicited any other Proposer to put in a false or sham proposal, and has not directly or indirectly colluded, conspired, connived or agreed with any Proposer or anyone else to put in a sham proposal, or that anyone shall refrain from bidding; that the Proposer has not in any manner, directly or indirectly, sought by agreement, communication, or conference with anyone to fix the proposal price of the Proposer or any Proposer, or to fix any overhead, profit, or cost element of the proposal price, or of that of any other Proposer, or to secure any advantage against the public body awarding the contract of anyone interested in the proposed contract; that all statements contained in the proposal are true; and, further, that the Proposer has not, directly or indirectly, submitted his or her proposal price or any breakdown thereof, or the contents thereof, or divulged information or data relative thereto, or paid, and will not pay, any fee to any corporation, partnership, company association, organization, bid depository, or to any member or agent thereof to effectuate a collusive or sham proposal. Note: The above non -collusion affidavit is part of the proposal. Signing this proposal on the signature portion thereof shall also constitute signature of this non -collusion affidavit. Proposers are cautioned that making a false certification may subject the certifier to criminal prosecution. State of California, County Subscribed and sworn to (or affirmed) before me on this day of 20_, by , proved to me on the basis of satisfactory evidence to be the person(s) who appeared before me. Notary Public Signature Notary Public Seal THIS FORM MUST BE COMPLETED AND INCLUDED WITH THE PROPOSAL. PROPOSALS THAT DO NOT CONTAIN THIS FORM WILL BE CONSIDERED NONRESPONSIVE. EXHIBIT I City of Santa Ana Human Resources Department RFP for Medical Services Review—August 27, 2018 26E -2S3 CITY OF SANTA ANA REQUEST FOR PROPOSALS FOR MEDICAL SERVICES REVIEW PROGRAM SAMPLE ADDITIONAL INSURED ENDORSEMENT FOR COMMERCIAL GENERAL LIABILITY POLICY Insurance Compainy This endorsement modifies such insurance as is afforded by the provisions of Policy # relating to the following: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its officers, employees, agents, volunteers and representatives are named as additional insureds ("additional insureds") with regard to liability and -defense of suits arising from the operations and uses performed by or on behalf of the named insured. 2. With respect to claims arising out of the operations and uses performed by or on behalf of the named insured, such insurance as is afforded by this policy is primary and is not additional to or contributing with any other insurance carried by or for the benefit of the additional insureds. 3. This insurance applies separately to each insured against whom claim is made or suit is brought except with respect to the company's limits of liability. The inclusion of any person or organization as an insured shall not affect any right which such person or organization would have as a claimant if not so included. 4. With respect to the additional insureds, this insurance shall not be cancelled, or materially reduced in coverage or limits except after thirty (30) days written notice has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. (Completion of the following, including countersignature, is required to make this endorsement effective.) Effective Policy # Issued to this endorsement form as a part of Named Countersigned by Authorized Representative SAMPLE ONLY City of Santa Ana Human Resources Department RFP for Medical Services Review — August 27, 2018 2tE 334 iEXHIBIT 2 AGREEMENT TO PROVIDE A MEDICAL SERVICES REVIEW PROGRAM THIS AGREEMENT, made and entered into this 15th day of January, 2019 by and between Concentra Medical Center dba Occupational Health Centers of California, a Medical Corporation (hereinafter 'Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City'). RECITALS A. The City desires to retain a medical consultant having special skill, knowledge and expertise in the field of medical services to provide a fully comprehensive and legally -defensible medical services review program as an essential part of the City's objective to provide and maintain a qualified work force. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance of this Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall organize, schedule, manage, and/or evaluate a comprehensive range of medical services and examinations, including but not limited to: a) For prospective and current City employees to perform the duties of the position for which they are being considered (pre-employment assessments), using pre- determined medical protocols for each job classification; such protocols may be modified by the physician, in consultation with the City's Executive Director of -Human Resources, or his/her designee, as is necessary to make a determination as to suitability for employment; b) For current City employees being considered for employment in Department of Transportation (DOT) and non -DOT positions requiring pre -placement or pre - assignment drug screens; c) Fitness for Duty examinations (industrial and non -industrial), and provide reports and recommendations regarding the suitability of current employees to continue to perform their duties; Agreement between City of Santa Ana and Concentra 25E-35 d) Urine and breath specimen collection, laboratory analysis and Medical Review Officer (MRO) responsibilities; e) Department of Motor Vehicles (DMV) Driver's License physical examinations; f) DOT -mandated drug and alcohol testing of employees considered 'safety sensitive' as defined under DOT regulations and City policy. Consultant shall ensure all such testing complies with DOT testing procedures as per 49 CFR, Part i 40; such testing to include pre-employment and pre=assignment. City shall be responsible for the organization, scheduling, and management of DOT and non -DOT "reasonable suspicion" drug and alcohol testing, and DOT "random" and "post- accident" drug and alcohol testing. Consultant shall facilitate evaluation of the results of said testing by qualified personnel, in accordance with the provisions of the Agreement and relevant laws and regulations. Consultant shall ensure that clinics used for DOT -related drug and alcohol testing maintain a current valid contract with a Substance Abuse and Mental Health Services Administration (SAMSHA)-certified laboratory. Consultant shall ensure tum -around time from specimen collection to obtained test results shall be a maximum of three (3) working days for a negative test, and a maximum of five (5) working days for a positive test. As part of the medical services review program, Consultant shall: 1) Analyze current job classification specifications and make recommendations for the City's use in the medical examination and drug testing process. 2) Provide training to Personnel Services personnel in administration procedures of Consultant's medical services review process. 3) Communicate with City Personnel Services staff regarding applicants' or employees' progress throughout the medical services review process. 4) Communicate directly with applicants and City Personnel Services staff throughout the pre-employment or pre -assignment process in regard to results and medical conditions as ascertained through the medical or physical examinations, 5) Provide an electronic final report in a format established by City Personnel Services staff at its sole discretion, outlining each candidate's pre-employment placement medical evaluation and results. 6) Provide quarterly electronic activity reports, in a format established by Personnel Services in its sole discretion, on the nature and number of examinations conducted, including but not limited to results and final dispositions. 7) Provide a detailed quarterly explanation and summary of charges incurred. 8) Provide all quarterly and annual summaries as required under the DOT; 9) Provide consultation as needed to Personnel Services staff regarding medical services provided and outlined in the Agreement. 10)Consultant solely shall review all pre-employment/pre-placement medical evaluation services and maintain records, pursuant to the Agreement, in accordance with State and Federal laws, or as otherwise reasonably required by the City, and to the fullest extent permitted by law. Agreement between City of Santa Ana and Concentra 25E-36 I 11)Consultant agrees to permit duly -authorized agents and employees of the City to review such records. 12)Consultant shall maintain all books, documents, papers, accounting records, and other evidence pertaining to the fees paid under this Agreement. Consultant will make materials available at their offices at reasonable times and notice, during the period of the Agreement and for three (3) years after date of final payment under they Agreement for inspection by the City or by any other governmental entity or Department participating in the funding of the Agreement, or any authorized agents thereof. 13)Consultant's documents shall not be used, duplicated, or disclosed to any other third partywithout written permission, unless such disclosure is required by law. Consultant shall not be required to create or maintain books and records not required in the ordinary course of Consultant's business operations, nor will the Consultant be required to disclose any information, including but not limited to product cost or pricing data, which Consultant considers confidential or proprietary. 14)Any Agreement changes which are mutually agreed upon by and between the parties shall be incorporated in written amendments to the Agreement. 15)lf the circumstances on a particular hearing and/or court proceeding warrant the presence of a competent and knowledgeable representative of the Consultant, the City may request and contractor shall provide such representative, at the rates provided in Exhibit A and upon proper HIPAA release. Additionally, as part of the medical services review program, Consultant shall: o Maintain a network of qualified and trained medical providers and.medical specialists for necessary exams; o Orient City staff in the legal/medical/risk management and human resources aspects of Consultant services; o Communicate directly with applicants to obtain the confidential medical information that is needed for clearance for a particular job; o Manage all bill review functions for the medical exams performed by clinics; and, o Provide access for City staff to Consultant's tracking system. Depending on job classification, pre-employment and pre -assignment medical examination processes may include: job profile review; review of medical history; check vital signs; detailed vision exam, including check of near/far/peripheral vision, Ishihara 14 and primary color; audiogram (if classification has specific occupational noise exposure or critical hearing demands); chest x-ray; EKG or treadmill stress EKG; Spirometry; chem panel 20; CBC w/diff; dipstick UA, or UA w/Micro (to lab); venipuncture & collection. Individual medical exams, such as post exposure, fit for duty, or other examinations, as needed, may include one or more of the following (*See Exhibit A): Agreement between City of Santa Ana and Concentra 25E-37 o Audiogram o Back X-ray o *Blood Lead Level ZZP o *Blood screens — 7 panel drug screen o *Blood screens — 9 panel drug screen o *Blood chemistry profile (SMA 24 or equivalent) o *Complete blood count (CBC w/diff) o Chest X-ray o DMV Physicals o Electrocardiogram o *Hepatitis "A" blood screen o *Hepatitis "B" blood screen o *Hepatitis "B" booster o *Hepatitis 'B" titer o *Hepatitis 'B" Vaccine (3 -injection series) o *Hepatitis "A" Vaccine (2 -injection series) o *Hepatitis "C" blood screen o *HIV blood screen o Pulmonary function test o Respirator Fit test o Respirator Physical o Respirator Questionnaire if PX is not required with clearance o *TB test o Urinalysis: ■ Urinalysis with microscopy (UA w/micro) ■ Urinalysis with dipstick (Dipstick UA) 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A, attached hereto and incorporated by this reference. The total amount to be expended under this Agreement, including the two optional renewals, shall not exceed $500;000. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on February 1, 2019 and terminate on January - 31, 2022, unless terminated earlier in accordance with Section 12, below. Agreement between City of Santa Ana and Concentra 25E-38 F The Agreement may be renewed up to two (2) times, for an additional one-year period each time, upon mutual agreement between the parties, and in writing executed by the City Manager, or his/her designee, and the City Attorney, or his/her designee and the Consultant. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an Independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Commercial General Liability Insurance. Consultant shall maintain commercial general liability insurance naming the City, its officers, agents, volunteers, and employees as additional insured(s) and shall include, but not be limited to protection against claims arising from bodily and personal injury, including death resulting therefrom and damage to property, resulting from any act or occurrence arising out of Consultant's operations in the performance of this Agreement, including, without limitation, acts involving vehicles; the insurance shall be primary and non- contributory with respect to insurance or self-insurance programs maintained by the City; and contain standard separation of insureds provisions. ii. The amounts of insurance shall be not less than the following: single limit coverage applying to bodily and personal injury, including death resulting therefrom, and property damage, in the total amount of $1,000,000 per occurrence with $2,000,000 in the aggregate. Consultant shall supply City with a fully executed additional insured endorsement in a form approved by the City Attorney's Office. b. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 of the Labor Code, Consultant, if Consultant has any Agreement between City of Santa Ana and Concentra 25E-39 employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. C. Errors and Omissions. Consultant shall maintain professional liability (error's and omissions) insurance, with a combined single limit of not less than $1,000,000 per claim. d. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (1) Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii) Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii) Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. e. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not affect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to, indemnify the City.for any work performed.pdor to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or effects, arising from this Agreement. Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or Agreement between City of Santa Ana and Concentra 25E-40 equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. I 7. CONFIDENTIALITY Consultant shall conform to all HIPAA requirements regarding examinations performed by Consultants. If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all nonpublic information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation of law; or (e) is independently developed by the Consultant without reference to information disclosed by the City. :8. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by fax or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the Council City of Santa Ana 20 Civic Center Plaza, M-30 P.O. Box 1988 Santa Ana, CA 92702-1988 Fax: (714) 647-6956 Agreement between City of Santa Ana and Concentra 25E-41 With courtesy copies to: f Executive Director of Human Resources City of Santa Ana 20 Civic Center Plaza, M-24 P.O. Box 1988 Santa Ana, California 92701-1988 Fax: (714) 647-6930 and, City Attorney City of Santa Ana 20 Civic Center Plaza, M-29 P.O. Box 1988 Santa Ana, California 92702 Fax: (714) 647-6515 To Consultant: Occupational Health Centers of California, a Medical Corporation 5080 Spectrum Drive, Suite 1200W Addison, Texas 75001 Attn: Legal -Contracting Email: LegalContractsaconcentra.com A party may change its address by giving notice in writing to the other party. Thereafter, any notice, tender, demand, delivery, or other communication shall be addressed and transmitted to the new address. If sent by mail, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, any notice, tender, demand, delivery, or other communication shall be effective or deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized Agreement between City of Santa Ana and Concentra 25E-42 representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, that terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party toy this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null; and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless -prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex (including gender identity and gender expression), marital status, sexual orientation and genetic characteristics (including genetic tests of the individual or the individual's family, and manifestation of a disease or disorder in the individual's family members, age, national origin, ancestry, or disability, as defined and prohibited by applicable law, in recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. Agreement between City of Santa Ana and Concentra 25E-43 F 14. JURISDICTION -VENUE This Agreement and all questions relating to its validity, interpretation, performance, and enforcement shall be government and construed in accordance with the laws of the State of California. This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature herein below has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. . All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA: MARIA D. HUIZAR RAUL GODINEZ II Clerk of the Council City Manager [Signatures continue on next page] Agreement between City of Santa Ana and Concentra 25E-44 10 APPROVED AS TO FORM: SONIA R. CARVALHO ' City Attorney By &o, A • Zlmt w Laura A. Rossini ' Senior Assistant City Attorney FOR APPROVAL: CONCENTRA MEDICAL CENTER DBA OCCUPATIONAL HEALTH CENTERS OF CALIFORNIA, A MEDICAL CORPORATION: Steven V. Pham Executive Director - Human Resources Department Jeffery Wainstein, MD President and Treasurer 77-0469725 Federal ID Number Agreement between City of Santa Ana and Concentra 25E-45 11 Exhibit A Services and Pricing i .Services Fees: PE — BASIC VITALS, SNELLEN, UA, EXAM $80.00 PE — DOT $99.00 PR— RESPIRATOR CLEARANCE EXAM ONLY)! $80.00 AUDIOGRAM $30.00 REVIEW — QUESTIONNAIRE — GENERAL $30.00 REVIEW — QUESTIONNAIRE — RESPIRATOR $30.00 RESPIRATOR FIT TEST — QUALITATIVE $50.00 *HEPATITUS A TITER ANTIBODY — BLOOD $50.00 *HEPATITUS ABC PANEL (ACTIVE INFECTION/IMMUNUITY TEST) — BLOOD $275.00 *HEPATITIS B —TITER SURFACT ANTIBODY QUANTITATIVE — BLOOD $60.00 *HEPATITIS C — ANTIBODY — BLOOD $55.00 *HIV $94.00 *VACCINE — HEPATITIS A 2 -DOSE SERIES $138.00 per dose *VACCINE — HEPATITIS B SHOW AS DOSE 1, DOSE 2, DOSE 3 $100.00 per dose *LEAD WITH ZPP — BLOOD $61.00 CHEM20/CHD/CBD/UA $55.00 *CBC W/DIFF $25.00 VENIPUNCTURE FEE $0.00 COLLECTION $22.00 *BLOOD CHESMISTERY PROFILE 24 $80.00 DS — URINE 7 PANEL NON DOT $60.00 DS — URINE 5 PANEL NON DOT $55.00 UA WITH MICRO — URINE $28.00 UA DIP STICK Included in physical CHEST X-RAY 1 VIEW $70.00 VISION — ISHIHARA $22.00 EKG —WITH INTERPRETATION $65.00 PFT SPIROMETRY $44.00 CARDIAC STRESS TEST $325.00 *TB SKIN TEST 1 STEP $37.00 Expert Testimony $250.00 per hour x After the first twelve months of this Agreement, if the current market price for the above Services change due to market conditions, demand(s) and/or shortage(s), the City will be billed the then current market rate. Agreement between City of Santa Ana and Concentra 25E-46 12