HomeMy WebLinkAbout25A - AGMT - MEDICAL SRVS REVIEWREQUEST FOR
COUNCIL ACTION'
CITY COUNCIL MEETING DATE:
MAY 19, 2015
TITLE:
AGREEMENT WITH OCCU -MED, LTD. FOR
COMPREHENSIVE MEDICAL SERVICES
REVIEW PROGRAM
{STRATEGIC PLA NO, 1, 5E}
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CITY MANAGER
RECOMMENDED ACTION
CLERK OF COUNCIL USE ONLY:
0210001--:4-11k
0 As Recommended
® As Amended
El Ordinance on 1 *� Reading
L7 Ordinance on 2'a Reading
[� Impiementing Resolution
® Set Public Hearing For
CONTINUED TO
FILE NUMBER
Authorize the City Manager and Clerk of the Council to execute an agreement with Occu -Med,
Ltd., subject to non- substantive changes approved by the City Manager and City Attorney, to
provide a comprehensive medical services review program for a three -year period expiring on June
30, 2018 In an amount not to exceed $75,000 per Fiscal Year, for total compensation not to
exceed $225,000 over the three -year period.
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It has been several years since the City has reviewed its current processes regarding employee
medical examinations, Staff issued a Request for Proposals (RFP) in January 2016. The scope of
work outlined in that RFP Includes the following:
Effectively coordinate, schedule and evaluate the results of a variety of medical examinations
for City employees, including;
o pre - employment medical examinations and screenings;
o post - exposure medical examinations and screenings;
o fitness for duty examinations;
o Department of Motor Vehicles (DMV) Driver's License physical examinations;
o certain Department of Transportation (DOT)- related drug and alcohol examinations and
screenings; and
o 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.
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Agreement with Occu -Med, Ltd.
May 19, 2015
Page 2 of 3
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.
A team of four City staff was organized to review the proposals. The following criteria were
established for review of proposals:
• Qualifications and Experience 25%
• Understanding the Scope of Work 25%
• Demonstrated Knowledge of Health and Safety Related Work 25%
• Staff Availability 10/0
• Cost competitiveness 10 %; and
• Responsiveness of the Proposing Firms and Fee Schedules 5%
Qccu -Med, Ltd. was the selected respondent to the RFP.
Approval of this recommended action will allow the City's Personnel Services Department to
Implement a comprehensive medical services review program that will streamline and expedite the
various medical processes required of our employees.
STR6TEG19 PLAN A IGNMENT
Approval of this item supports the City's efforts to meet Goal ##7 Team Santa Ana, QMjective ##6
(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).
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Agreement with
May 19, 2015
Page 3 of 3
Occu -Med, Ltd.
FISCAL IMPACT
Funds are budgeted in fiscal year 2015 -16 Liability and Property Insurance account (60% account
no. 08009051 - 62300), Workers' Compensation account (20% account no. 08209054 - 62300), and
Personnel Services account (20% account no. 01109050- 62300).
Edward S. Raya
Executive Director
Personnel Services
APPROVED AS TO FUNDS AND ACCOUNTS:
Francisco Gutierrez
Executive Director
Finance & Management Services Agency �✓
Exhibit: Agreement between the City and Occu -Med
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CONSULTANT AGREEMENT
THIS AGREEMENT, made and entered into this 19`h day of May, 2015 by and between
Occu -Med, Ltd., 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 ").
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, as set forth in its Proposal dated February 9, 2015
attached hereto and incorporated herein by reference ( "Exhibit A "), 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 Personnel Services
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.
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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 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. Consultant shall comply with all
state and federal laws including but not limited to the Health Insurance Portability and
Accountability Act of 1996 and the Genetic Information Nondiscrimination Act of 2008.
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 City Personnel Services staff 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.
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
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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 Consultant shall provide such
representative, at no additional cost to City.
Additionally, as part of the medical services review program, Consultant shall:
• Maintain a network of qualified and trained medical providers and medical specialists for
necessary exams;
• Orient City staff in the legal /medicallrisk management and human resources aspects of
Consultant services;
• Communicate directly with applicants to obtain the confidential medical information that
is needed for clearance for a particular job;
• Manage all bill review functions for the medical exams performed by clinics; and,
• 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:
• Audiogram
• Back X -ray
• Blood Lead Level ZZP
• Blood screens — 7 panel drug screen
• Blood screens -- 9 panel drug screen
• Blood chemistry profile (SMA 24 or equivalent)
• Complete blood count (CBC w /diff)
• Chest X -ray
• DMV Physicals
• Electrocardiogram
• Hepatitis "A" blood screen
• Hepatitis "B" blood screen
• Hepatitis "B" booster
• Hepatitis "B" titer
• Hepatitis "B" Vaccine
• Hepatitis "A" Vaccine
• Hepatitis "C" blood screen
• HIV blood screen
• Pulmonary function test
• Respirator Fit test
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• Respirator Physical
• Respirator Questionnaire if PX is not required with clearance
• TB test
• 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 its Proposal ( "Exhibit X). The total
annual sum to be expended under this Agreement shall not exceed $75,000.00,
with total compensation over the three year term not to exceed $225,000.00.
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.
ter: %r
This Agreement shall be for a term of three (3) years, commencing on July 1, 2015 and
terminating on June 30, 2018, unless terminated earlier in accordance with Section 12, below.
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:
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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, $2,000,000 in the aggregate. 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.
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:
(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.
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 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
25A -9
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 Health Insurance Portability and Accountability Act
(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 facsimile or other telegraphic
communication in the manner provided in this Section, to the following persons:
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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
Facsimile: (714) 647 -6956
With courtesy copies to:
Executive Director of the Personnel Services Department
City of Santa Ana
20 Civic Center Plaza, M -24
P.O. Box 1988
Santa Ana, California 92701 -1988
Facsimile: (714) 647 -6930
City Attorney
City of Santa Ana
20 Civic Center Plaza, M -29
P.O. Box 1988
Santa Ana, California 92702
Facsimile: (714) 647 -6515
To Consultant:
Occu -Med
2121 West Bullard Avenue
Fresno, CA 93711
Facsimile: (559) 435 -7200
Phone: (559- 435 -2800 (x207)
Attn: Christopher St. George
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 facsimile, 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.
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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 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 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.
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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.
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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:
SONIA R. CARVALHO
City Attorney
By: mac_ " t
Lisa Storck
Assistant City Attorney
RECOMMENDED FOR APPROVAL:
Edward S. Raya
Executive Director of the
Personnel Services Department
CITY OF SANTA ANA:
DAVID CAVAZOS
City Manager
CONSULTANT:
Christopher St. George,
Director, Global Business
Federal ID Number: 52 -23335
io
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Exhibit A
Scope of Services /Proposal
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1
1
1
► City of Santa Ana
1 Response to Request for Proposal (RFP) Medical Services Re%iew
1
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! Proposal Submitted b);
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!
! OCCU -MED
!
F'chruan 9. 20 15
! Corporate HQ - 2 12 1 West Bullard Avenue, Fresno, CA 93711
! 'FAX 1[):522333519
! 559.435.7200 - Faz
Contact:
Chris St. George
559.-435.2300 x207 - Telephone
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Mary Kelley
Project Manager
City of'Santa Ana
20 Civic Center Plaza, M -24
Santa Ana, CA 92702 -1988
1
RE: Request for Proposal of Medical Services Review
Cover Letter
u
Dear Ms-. Kellett:
I
CAllt'� �.,t�r�i rl.i alt
Occu -Med has over a 35 -year history of providing our quality- driven, customer - service oriented
Pre- Placement & Periodic Medical Evaluation Program to hundreds of cities and counties
throughout California, forming close working relationships with human resources and risk
management staff members with virtually every municipality we work H ith. Our consulting
services allow our clients to continually access a turnkey system for completing medically
appropriate and legally defensible pre - placement and periodic medical evaluations.
Occu -Med's methodology for providing medical eva]uation services will consider the City of
Santa Ana's need for an end -to-end solution in managing what is oftentimes one of the most
challenging aspects of the on- boarding process. In addition to providing our core medical exam
review service called EXANI,CQA, Occu -Med's services include the scheduling and tracking of the
entire evaluation process and we ensure that results are furnished to Occu -Med for review in as
timely a manner as possible. Occu -Med has been proud to continue to serve many cities in
Southern California providing this exact same service to dozens of cities including some of your
neighbors: the City of Anaheim, the City of Costa Mesa and the City of Fullerton's Police
Department. Regardless of how simple or dynamic an evaluation might be we ahvays furnish a
clear and legally defensible medical recommendation as to whether or not each applicant is able
to safely perform the essential functions of the job with or without reasonable accommodation.
As ue continue to perform our service for our hundreds of clients in California, nationwide and
around the world, we are pleased to present our proposal for your review, and we uroWld be
honored to begin providing out- services to the Citp of Santa Ana.
t OCCn -Merl appreciates this opportunity and xsc look I'orrvard for hearing from you.
t Sincerely,
Christopher St. George
Director, Global Business Services
212114 cni BuI III Id -'O 0n ❑e. Fresno. Cali kmiia 93711 - ) 0) 181111 1-m: 5i9.43i.7211n 1 ,�,cw,occwmcd.ann
25A -17
City of Santa Ana Response to RequesL for Proposal (RFP) Medical Serx ices Rex iex
Table of Contents
Page Number
(\'mpuo�|dkntiDmtinn COVER PAGE
Organizational and Credentials }
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DUUns/Re iog, is
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Appendices
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1
City of Santa Ana Response to Request for Proposal (RFP) Medical Son ices Review 1 219/15
1. Organizational and Credentials
OCCLI -Med'S founder (now President and C E'0 of' the coin pan)) directed it project (which evuntuall)
ec)ended more than `62 million in cash and in -kind contributions) funded b) the United Suites Civil
Service Commission in 1976 "to develop and implement nn improved system of physical and medical
standards and procedures for employment" The goals ol'this project were: a) to ensure workers were
able to safely perform the essential function of theirjobs, b) reduce the costs associated with worker
injuries, and c) protecting the rights of the disabled b) developing a medically appropriate and legally
deronsible methodology for determining what medical conditions, injuries or illnesses allowed for
reasonable accommodation. 'The Director ol'this project, Jim .Johnson, having spent his previous two
years at the Connt) Supervisors' Association of California ("CS AC-) as, among other assignments, staff
to the statewide association of District Personnel Administrators, obtained a secondary grant to expand
this project to include the entire state of California and to form an Advisory Group of representatives
from more than thirty Counties, several Citics and various state and federal agencies enforcing the newl}
enacted legislation protecting the employment rights of the handicapped. Based on the original research
conducted then, Oceu -Med's methodolog) for managing employment medical evaluations was born.
Occu -Med has gained a thorough understanding of employ ment laws and regulations over its 35 years of
providing these services, and we know the importance of having a complete Understanding of the physical
1 and environmental factors that the employee will face in the workplace before a placement
recommendation is made. Oceu -Med has both legal and medical staff, and, because awe thoroughly
understand medicine, the law and the requirements of he job in question. Nie are able to confidently
permit placement of applicants and employees n\ ho Lire able to safely perform the essential duties of the
,job with or without reasonable accommodation and are able to recommend (just as confidend }) the
disqualification of individuals who are Unable to sarcl) perform the essential cluties of the job (again, Mt It
or without reasonable accommodation). For example. as part of our scn ices NA track. monitor and opine
on updates to the Occupational Health and Safety Administration (OSHA) and the Americans with
Disabilities Act Amendments Act or 2ow (ADAAA). Health Insurance Portahiliq and Accountahilit)
Act (HIPAA), the California hair Employment and Housing Act (FEHA). Peace Officer Standards and
Training (POST) Guidelines and National Fire Protection Associated Guidelines (NFPA) 1582 o -hich
sometimes go unnoticed b) Risk Managers and ESH &S personnel, 3 o it, is the employer who will be left
to pa) the bill should an applicant be tested inappropriateh during a pre- placunent medical exann. And
just as importanti) awe ensure the quality of each clinic, proN ider, and lahorator) in our medical network
including: ,Joint Commission, State Medical Board and SAMHSA accreditation. We believe it is-
? Occu -Med
25A -19
City of Santa Ana Response to Request for Proposal (UP) Medical Sen ices 12ca iew 12/9/1"
incumbent upon Occu -Med to remain an authority in the relevant legal changes within which such
emp]oytnent clecisions must be macle. We hate received numerous testimonies fiom our clieais regarding
the quality or our SCII iCe. Some of Occu- Nled's client references are included as Exhibit D.
Oeeu -Mad is open Monday- Friday 7am -6pm PI'. OCCn -Med maintains multiple offices throughout the
United States including one in Dem er, CO and another in Fort Worth.l'X. Between the three (3) offices
we maintain an average staff ol'approximately 50 employees. Correspondence regarding our proposal or
any negotiations can be directed to Christopher St. George at either address listed on our cm er pave or by
phone at: 559.435.2800 x207.
Qualifications and Experience of Key Personnel /Staffing
Occu -Med's Medical Director is Deconna M. Kaji M.D.
Dr. Kaji gtatduated Magna Cum Laude from the University of California, Berkeley and the University of
Hawaii, John A. Burns School of Medicine. She received her surgery training at the University of
Southern California and is a Board Certified Urologist. She has served as Professor of Urology and
Assistant Chief of the Department of Urology at the Children's Hospital of Los Angeles, the University of
Southern California and the University of Colorado. Dr. Kaji has served on Occu -Med's Board of
Directors and managed its Medical Adcisop Board for more than 30 years, and she has been the
Company's Medical Director for more than 20 years. She has participated in all of the Company's
medical research, having met with the medical specialists and sub - specialists representing 12 separate
body systems who initial]v formulated Occu -Med's Compendium of Medical Standards. She has
continued to supervise and participate in every medical research meeting addressing the continued
efi'cctiveness and appropriateness of this Compendium of what is now termed Medical Guidelines, Dr.
Kaji supervises all medical specialists currency on retainer to Occu -Med. Further, as Medical Director,
Dr. Kaji oversees all medical aspects of the Company's EXAMQA program.
LiCenSUre documents for Dr. Kaji & our Laborator) enclosed as (APPENDIX A).
25A -20
City of Santa Ana Response to Request for Proposal (RFP) Medical Services Review
Occu- Nicd's project manager for at least the first Near of this
contract %till be Scan Edin, PTA (Pictured right).
Mr, Edin is a certified physical therapist assistant and has
performed hundreds of job analysis sessions and thousands
of craluutions for Occu -Mod clients throughout the United
States. These aspects of hisjob alloss him to see many
different job classifications enhancing his consulting
abilities, and coordination in medical appropriateness
with I:h. Kajl and legally defensibilit) with Jim Johnson, J.D.
(More inf n-matiat regarding Mr. Johnson can be founrd on
Page 3 gfour Propos(O. Whether thejob
class is it Librarian or Police Officer, Mr. Edin is able
to synthesize the critical data in a job in order to ensure
quality and continuity in our client employer's occupational
medicine Program. Mr. Edin currently oversees multiple
other Occu -Med clients throughout California focusing on
Cities, Counties and Special Districts.
It. Scope of Services (Technical Proposal)
2/9/15
Occu -Med contracts with multiple medical presiders throughout the Orange County area which will
allow the City's applicants and employees to ahamIs attend an appointment close to his or her current job
or home, This service extends be) 'ond the Cith's immediate geographical area, as Occu -Med has over
5,000 medical prof iders nationwide, so no matter where the Cit) is recruiting from rest - assured
Oceu -Mcd will have a clinic nearby (qualifications enclosed as part of Appendix A). C'urrentl}
OCCU -Med's primary network of clinics for the City of Santa Ana will consist of:
Gateway Medical Associates Hoag Clinic USHealthcvorks
Anaheim, CA 'hustin, CA Santa Ana. CA
5 1 Occu -Med
25A -21
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City of Santa Ana Response to Request for Proposal (RFP) Medical Services Review 12/9/15
Legally Defensible Job Analysis
Evcry medical exam performed by Occu -Med is done so in order to comply +vith a legal requirements
surrounding what is permissible for pre- placement and periodic medical evaluations tinder the ADAAA,
FEHA and GINA. Put simply, we do notjust ask the applicant or employee if he or she is able to "do the
job" or `return to work ", rather, our approach provides a quantifiable vsay to make such a determination
for each appiicantand/or employee as part of an individualized assessment.
The cornerstone of creating legal defensibility in Occu -Med's EXAMQA Occupational Medicine Program
begins with the administration of Job Analysis, i.e. initially validating all medical testing performed
through a statistically validated method. Job Profiles (see APPENDIX R) are prepared for use in
evaluating pre - placement. Fitness- for -duty and return -to -work medical e- xaminations by conducting- on-
sitejob analysis sessions. The procedure utilized during thejoh analysis sessions is the same one that we
have used for more than 3,000 other agencies: Physical Abilities Analysis,
Physical Abilities Analysis is a structured group process that involves interviewing job Incumbents from
thejjob being analyzed. Lt preparation for thesejob analysis sessions Occu -Med works with the City to
determine statistically valid sample sizes (number of job incumbents) for thejob classes and schedule the
sessions. During the job analysis sessions, Incumbents are asked to identify the most demanding essential
,job tasks for 19 physical ability categories, and then they are instructed to rate those tasks on a 7- point,
behaviorally - anchored scale. The incumbents are also asked to complete a questionnaire that addresses
the environmental factors that the) may be exposed to in their job. Overall, each session requires about
one and one -half hours to complete.
Data collected will then be qualitatively and statistically anal) zed to develop Job Profiles and Medical
Examination Component Profiles For cach,job class studied. The .lob Profile accurately and fully the most
demanding essential ,job tasks of thejobs studied, and the Medical Fswuinmion Component Profile (see
APPENDIX C') details the specific medial tests that are job- related and consistent with business
necessity and therefore recommended to find or diagnose the medical or physical conditions that mould
be of concern for that,joh.
6 ; Occu -Med
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City of Santa Ana Response to Request for Proposal (RI-13) Medical Services Review 1 2/5/13
Additionally, as part of our job analysis
I
OCCn -Med can include a review of the City's
1 PHYSICAL AHILtTtE$
current testing protocols and procedures to
1
determine if any additional CAL /OSHA
1 99u 4anW N
.j
I specific Costing could be included as part of the
pre- placement medical exam. Or, the City'sF,.
1 desire to review its tiro b testing policy in light
NF{SIAO Y j G {. Vr °VnC CQAaq
¶ - V[Gn1ANn *tlA
a
of the Lanier Case.
1 I
eu . »A ) s s i t � srnna anisAarn
Oceu -Med projects that it can accomplish an _
'»UMN A7 CN 1 `% pYNM1N4I'.CYIXi4T/
anslasis of all required City Job classes in no
x
1
mole than one weeks tnYle. This presurnes that nnN.x ^ 1 + [s[exr xseunrL. *•
I s.ram.a°[ 7
the City can schedule the I -2 hour sessions
4wfe 3vtlY
'
efficiently tvi[h at Mast 4-5 job classes c..4a.,.Aw. ^rear„ s' ,T
represented per session and an adequate
� Orvnn°gv j 'v •'i NenNe4 Pe[aXnlir
Lme Naveacni ..!
amount of incumbents in each job class. t iJ
r
The City could expect Co pay $ I ,000 a day nnXranr �
(..
� For each day of onsite work performed and '
o,AN »rG rlien9 +N
another $1,000 for any offsite work performed.
Occu -Med estimates we could complete all necessary analysis in I -weeks time (with another eek
needed to wrap -up off -sire work).
With the completion of Job Analysis and approved Medical Exam Component Profile the Cite can be
confident that all medical testing is job related and consistent with business necessity. After our initial job
analysis is coin pleted Occu -Med can on an annual basis refresh the City's Job Profiles to reflect changes
to the physical demands of the position. This gill also be performed for the City's Medical Exam
Component Profiles in order to stay compliant with changes to applicable laws, like the Lanier case, or
ulxlafes to Guidelines like POST or NFPA. OCCa -Med is prepared to begin vt'ork for the City on March 3,
2015, or sooner, in order to ramp -up. NOTE: If the City elects not to purchase this service Occu -Med
can work from the City's existing ,Job Descriptions and Medical Examination Protocols, Our,job
analysis service can always be performer) at a later date.
' Occu -Med
25A -23
City of Santa Ana Response to RCgUe51 for Proposal (RFP) Medical serf ices Re%ioN 2/9/15
As an additional value tojuh analysis. this Program will provide the Cite an effective method of
n'ranaging the pussihlC retut'n [o cork of employees who require a medical lent e of absence clue to injut'y
or medical conditions, as Nrcll as tm Americans With Disabilities (ADA) and the ADAAA /FEHA
compliant reasonable accommodation forum for cngaWing such empIoN ees. Occu -Med's FFDAR fW
Program is currently in use by hundreds of employers nationwide. OCCU -Med is uniquely positioned to
assist the City with the human resources matters ho oh ing complex medical cases that require a prompt
and discerning assessment of the medical factors that m¢q constitute a contraindication to an employee's
performing one or more of the essential functions of the his /herjoh.
Implementation /Work Plan
A. Pre - Placement Medical Evaluations
PREAMBLE
QA' is the name g're'en to Occu -Med's end -to -end solution for the scheduling and on -going review of all
medical examinations for applicants or employees for Jobs with the Cif; . When applicable the same
methodology outlined in this section for scheduline, tracking and reporting the result of the medical
exam kill he applied Nehen schedulin.o annual, stu-+eillancc and Fitness- for -dut) exams as Neell. This
service includes Occu -Med's revie%r of exams, the further im osti,ation of medical conditions identified
during these exams (through the °RDQA" service- -see description). the preparation of letters to applicants
or employees who are determined to be Medicall) Disqualified for thejoh for Nvhich the) applied or
currently Ncork -in, an analysis of Reasonable Accommodation for each individual Medicall} Disqualified,
and the preparation of periodic (dailk . when useful) production / performance / status reports.
Scheduline
Schedulim_ pre - placement. or periodic medical exams through OCCa -Med could not be easier. A City
representative contacts Occu -Med's Exam Scheduling hotline or submits an Occu -Med Exam
Requisition Form vin e -mail (see APPENDIX D), and the necessary medical exam is scheduled the same
day as the referral. OCCLINCLI Ncithin two (2) hours of receipt of your referral NN ill contact y our applicant
or employee in order to arrange a medical appointment NN ith him or her. Upon completion of scheduling.
NOUr representalh C Neill immediately re ek c cmail confirmation of [lie appointment time and date, Nv hich
will he scheduled to occur within 2 business da) s of the refcrrul Foras directed b) the ('ity ). NormallN,
the exam Neill he scheduled at: one of the local medical prW ideci identified xm ov er. NN ith Nour
permission, exams could be scheduled at an alterMitike nearby clinic if the preferred clinic is hooked out
i- Occu- Med.,.... .... ..
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City of Santa Ana Response to Request for Proposal (RFP) Medical Services Re%iew 1 215/15
beyond acceptable time periods or if the applicant lives closer to an alternative clinic. Upon scheduling
the medical exam the applicant is pros ided in advance all the necessary paperwork in order to complete
the exam successfully. This includes a copy= or OCCU -Med's GINA compliant medical history forms (see
APPENDIX E) avhich are used in place of the local medical providers forms. We do this to ensure no
inappropriate medical history questions are solicited as often times, clinic specific forms lack compliance
as they are used for various other types of` medical eva] uations.
Having scheduled the medical exam, and with knowledge of the length of time required to obtain results
from the medical testing included in the exam (i.e., PPD test for tuberculosis takes 48 to 72 hours for
results), Occu -Med contacts the medical provider to request, or "hareest," tlae exam at the absolute
1 earliest time that it should be ready for review. This service has cut exam turnaround time for our clients
1 in half in almost every case. Thus, eliminating a clinic from "holding" an exam until they hire staff that
I can fax or email the results. Occu -Med commits to submitting a Medical Exam Summary Report to the
I City on the same day the complete medical exam is received (provided it is received before 4:OOPM II
EXAMQA
When reviewing an exam Occu -Med combines;
a) a thorough knowledge of the essential physical and environmental components of'the, jobs in
question;
b) the medical expertise to gather all necessary and appropriate medical information upon ra -hich to
base safe placement, return -to -work and fitness -for -duty recommendations; and,
c) extensive knowledge of the legal constraints e ithin «hich such hiring decisions must be made.
This aspect of our services means that Occu -Med and its medical revieav staff review all completed
medical exams aid it is Occu -Med's recommendation that is made to the City regarding an applicant or
employces safe placement. This process ensures that pertinent aspects regarding a placement decision are
considered and not
,just those in the examining physician's pun iew. For Conditional Qualifications WQ).
an Employment Agreement accompanies each such report, For Recommended Delaycd for Qualification
(RDQ), RDQA is initiated ra ith the applicant, and the City is simply notified that the process has begun.
phis eliminates the possibility of disclosure of protected personal medical information that may be
undesirable for the City to have received. For each Disqualification (DQ), an appropriate medical -legal
report is submitted documenting the specific.jt1Aifications for the disqualification and hilorrning the City
of the requirement of a consideration of Reasonable Accommodation In process in which we encourage
l 1 Octu -Med
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City of Santa Ana Response to Request for Proposal (RFP) Medical Services Review 12/9/15
the Cit) to involve us). Periodic performance reports,addressing both clinic turnaround statistics and
EXAMQA results. area vailable upon request.
Details regarding Occu -Med's qualification recommendations are -its follows;
Occu -Me&s Qualification Recommendations and Reports
Medically Qualified — Applicant is an immediate safe ph cement.
Condition all) Qualified - Applicant may be placed immediatcl but has work restrictions or
accommodation as outlined on the medical restrictions and /or reasonable accommodations page of the
report. The specific restrictions or accommodations are alwa) s included as part of the Conditionally
Qualified Medical E.eum Summary Report,
Recommendation Delayed for Qualification — Applicant kill be required to submit further information
regarding one or more medical conditions before being olgged.. 'I`his process is facilitated hp Occu -Med
via RDQA. The applicant is contacted on the da) that he /she becomes delayed and informed that he or
she has 10 business days to complete the request for additional medical information (extensions of the
timeframe can be granted at the City's discretion).
Medicaly Disqualified —AM llicant has been teemed mudicetl y unsorted for -this job clLiss�jijd ,\� ill not be
placed. Occu Med's report outlining relevant issues will be attached the Cite must consider Reasonable
Accommodation For this Medical Disqualification and must determine whether such an accommodation is
feasible.
r
Recommendation Delayed for Qualification — RDQA
1
I The RDQA process is one of the most elegant and sophisticated S011 fees associated frith the OCCLI -Mecl
I Program.
1
t
When the OCCLINed recommendation is that a decision be delayed until certain medical information can
r be further explored (that is, when the applicant is classified as "Recoinmendation Delayed for
Qualification " —or "RDQ" —under Occu -Med terminology), OCCLI -Med will submit that report its well as
an additional report when the requested additional information is received and Occu -Med is ahle to offer a
conc Lis! %e placement recommendation. Since the law permits making "further medical inquiry" into
medical conditions that could pose a direct threat of injury from the performance of the Job's essential
duties, it is naccssar) to notif) the applicant of the specific findings as well as the information that will be
ncoessarN to submit in order to be cleared for the job. Since <'itp s 1PY may not hat c the time or the
Occu -Med ......___....
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City of Santa Ana Response to Request for Proposal (RFP) Medical Services Review 1 2/9/15
c
medical expertise to contact each or these applicants to describe in detail the medical findings and to
L
answer their questions about the medical information needed for clearance to be approved, Occu -Med
staff communicates directly with these applicants. Further, there is also a growing fear by employers that
they may to receiving medical information about,job applicants from medical examinations in violation
of state and federal laws relating to such information (specifically, when the medical condition being
investigated more fully pursuant to an "RDQ" designation is found to be benign in relation to the
, job's
essential duties). For these reasons OCCU -Med has developed —and will institute as part or this Contract-
-a service designated as "RDQA." Under RDQA Occu -Med corresponds directly with job applicants to
discuss the medical findings, to answer any questions about the medical condition or the process being
employed, and to describe any medical records or documentation required for clearance. Applicants u111
have five (3) clays to respond to Occu -Med and ten (1 t) days to provide further information unless the
City dictates the application of different time requirements. The City's staff %A ill simply be notified that
such a review has been initiated, and the City o ill be informed on a periodic basis (as directed) on the
j status of each RDQ. Then, when the requested information is submitted, Occu -Med will prepare the
1 appropriate clearance report.
Occu- Portal
At the request of the City results will also be made available vin an online hveb -based portal known as the
Occu- Portal.
Occu -Med will provide personnel, designated as authorized by the City. with access to the Occu -Med
Portal. This web -based tool i\ ill permit designated the City's personnel to access real -time statuses of
individuals referred to OCen -Med for evaluation. Additional tutorial information regarding utilizing
Occu -Med's vendor portal will also be made available online shouI(I ne +% users need training on the site.
OCCU -Med will also provide to the Cit) . at its convenience, a telephonic or face -to -face walk- through of
our portal features so that the Citx can customize which fields it hvishes to have appear on the portal.
Occu -Med will create vendor logins for six (6) City personnel . and more can he added at the City's
convenience. Login access will be emailed by OCCLI -Med to the designated City representatives. It will
be incumbent upon the City to notify Occu -Med should a represenualk c change or no longer require
access. Occu -Med's web -based portal utilizes individualized logins for each client contact and protects
data transmission by Uliliziog a I28 -bit SSL security certificate. If the City desires to utilize this service a
nominal monthly charge per user \i ill be applied (see Exhibit C).
It ( Occu -Med
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City of Santa Ana Response to Request for Proposal (RFP) Medical Services Review 12/9/15
As part of Occu -Med's sen ices Occu -Med serves as the custodian of records for all medical records for
our clients. Occu -Med maintains this information in it HIPAA compliant softcopc that is available to the
City with a one (I )- business day request.
B. DOT MANDATED ALCOHOL AND DRUG TESTING SERVICES
Drug screening at mane clinics is "hit or miss." Additionally, if a Medical Review Officer (MRO) is ever
required, that service is subject to a separate fee. And, finally, many issues that arise are beyond the
experience of the clinic to address (i.e., dilute negative tests and shy bladder). Occu -[vied has developed it
national program that manages all such drug screening issues for its clients, including assisting in the
development of drug screening programs and procedures, pursuant to CFR Title 49 Part 40, Further, due
to our national purchasing power, v are able to offor attractive pricing kith no add -on charges for MRO
sen ices. Further, the are readily available to address any issues in this area that arise this service will be
substituted for the clinic's typical program, ensuring compliance for the DOT drug screen program.
Licenses for Occu -Med's SANIHSA & CLIA accredited lab are enclosed (see APPENDIX A),
Urine Collections
OCCU -Med along with selected medical clinics on our network are able to provide the City a
comprehensive solution for collecting DOT urine drug screens and BAT in compliance with CFR Titio
-49. PART 40.
Collection sites where the DOT collections can be performed are located in Oecu -Med clinic nettcork and
available throughout (tic Cite and Orange County, and more sill be added based on where the City
identifies the need to hate locations for post- accident and after -hours testing.
Only Certified Specimen Collectors having received the CFR Title 49, PART40.213 Training will be
used for these collections.
All urine results will be sent to MED'TOX Laboratories foreonfinnation. Metim is SAMHSA certified
(Federal Rcgiswr/Vol. 79, No. 27 /Monday, February 10, 2014lNotices), and is able to conduct
confirmatory tests using the split - specimen regulations and MP.O confirmation. 'These results are
t) pically available within 48 -72 hours. with up to 72 additional hours needed if MRO confirmation is
12 1 occu -Med
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City of Santa Ana Response to Request for Proposal (Rf-'P) Medical Services Review 1 2(9115
required pursuant to a DOT requirements for a positive finding using GCMS confirmation. When MRO
confirmation is required the City will be notified of the delay.
1
Breath Alcohol Collections
1 For BAT confirmation only FBI's on the NHTSA CPl.for evidential devices that meet the requirements
1 of CFR -title 49, PART §=40.231 (b) will be used to conduct alcohol confirmation. These results will be
1 immediately available to the City.
C. COMERCIAL DRIVER PHYSICAL EXAMINATIONS
t Pursuant to 49 CFR § 391.41 Department of fransportation Physical Qualifications and Examination of
Drivers Motor Carrier Safety Regulations, a DMV medical exam will be administered. A Department of
Motor Vehicles Medical Examiners Certificate per 49 CFR 391.41 -49 will be prepared by the examining
medical provider and will be given to the employee with a copy emailed by OCCU -Med to the City's
Human Resources Department. Pursuant to the May 19, 2014 revisions to the Federal Motor Carrier
t Safety Regulations Occu -Med will ensure all medical providers conducting DOT exams are certified on
the National Registry.
As required, Occu -Med will also schedule ancillary required commercial driver components including but
not limited to: DMV DL 51 Medical Examination Report requirements and Audiometric baseline per
CCR Title 8 § 5097 (audiogram an to assess hearing between 500hz: 6000hz). Information will be
recorded in accorda nce with CCR Title 8 § 5097.
D, FITNESS- FOR -DUTY EXAMS
Intensive Return -To -Work Program (IRTW)
Occu -Med, through its Fitness -For -Duty (FFD) and Intensive RCtUrn -To -Work (IRTW) Programs.
focuses on delivering employer- oriented analysis regarding injured or disabled employees. Occu -tiled has
been an industry leader in employee health solutions for over 36 years, and, through its IRTW diaision, its
medical and legal expertise is concentrated to provide employers with a valuable perspective on
evaluating whether or not an employee, as a result of an injury or medical condition, can continue to
perform the essential functions- of a,job with or without reasonable accommodation.
13 1 Occu -Med
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City of Santa Ana Response to kequest for Proposal (RFP) Medical Sei%ices Re%ielN � 2/9/15
Occu -Med's IRTW Program +till pro%ide the City an effe'ctire method of managing the possible return to
%vork of enaplo%ces %v ho require a medical lea%e of absence due to injury or medical conditions, as well as
an Americans With Disabilities (ADA) and Fair Employment and Housing Act (FEHA)- compliant
reasonahle accommodation forum For engaging such emplo)ces.Occu -Mud's IR "f W Program is currently
in use by hundreds of municipalities, mater agencies and fire districts. Occu -Med is tin iquely positioned
to assist the Cit) kkith human resources matters inkoh ine complex medical cases that require a prompt
and discerning assessment of the medical factors that ma) constitute a contraindication to an emplo)ee's
performing one or more of the essential functions of the his /herjob.
Occu -Med's ecpert staff guarantees the quality and timeliness of its reports. Our experts range from
phcsicians, nurses, and physical Therapists to legal and human resource professionals. It is through our
expert staff that a quality and consistent service is rendered. Occu - Mud's staff and consulting ph) Sicitms
as well as other medical providers represent a considerable breadth in Carious medical fields including:
Cardiolog) , Internal Medicine, Occupational Medicine, Family Practice, urology, Optometry,
Orthopaedic. Rheumatolog), Gastroenterology, Neurology. To.eicology, Pathology, Psychiatry and
Ps) chologr, as %cell as a consulting audiologist, Our staff and consulting medical providers ensure that
our recommendations are medicall) appropriate and employer oriented. Additionally, by maintaining
legal staff, our clients can be confident that our recommendations are also legall) defensible.
Occu -Med's IRTW Program is ready to be implemented immediately as a turnkey model to the City -. The
program is designed to provide the cl ient kith the information necessary to make an informed decision
regarding anti employee's ability to safely perform the essential Functions of his or herjob by means of a
legally defensible recommendation. The IRTW Program strategically applies Occu -Med's medical and
legal expertise in order to render medical anal)sis and recommendations regarding the facts of an
evaluation "hi Ic considering the applicable hoes and regulations. Thus, we also render legally defensible
recommendations throughout the reasonable accommodation process.
The evaluation begins %kith an assessment of the factors causing the need I'or the evaluation. This process
is formally started by the submission of the requisition Form (APPENDIX F).'fhe requisition farm
requests the employee's contact information, ajob description (if a Job Profile has not already been
dereloped), and other peripheral information pertinent to the emplo)ce's situation. The goals are toreduce
risk through obtaining specific medical information to determine %khether or not a pertinent medical
condition, injury ,or medication being prescrihed will affect the employee's ability- to safely perform one
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City of Santa Ana Response to Request for Proposal (RFII) Medical Services Revic�r 1 2/9/15
or more of the essential functions of the job and to save time by eliminating costly delays.
Obtain Medical Information
Nest, Occu -Med selects the appropriate physician to pro% -ide the needed medical information (this can be
the treating physician or an independent specialist). Occu -Med contacts the employee b) issuing an
Individualized Assessment' /Reasonable Accommodation Letter. The Individualized
Assessment /Reasonable Accommodation Letter will introduce Occu -Med to the employee as the City's
healthcare and human resources consultant and will explain that the IRTW Evaluation is an ADA /FEHA
compliant reasonable accommodation process. Additional[), the letter will inrorm the employec of the
necessary steps and information required to complete the IRT'W Evaluation. The letter, to be made
available to the appropriate physician or physicians designated, requests the specific, appropriate medical
1 information that will be necessary to determine uahcther the employee continues to be an appropriate
1 placement in the job, with or without restrictions. When such medical information is submitted, our
1 medical stuff evaluates it in conjunction with the essential functions of the employee's job to determine
1 whether a contraindication to,job performance exists.
1
Recommendation
Occu -Med delivers a recommendation to the City through verbal communication rollowed by a lcgally
defensible written report outlining the specific process that occurred and how the recommendation �%as
determined (all u%hile protecting the confidentiality of all medical information that is not job related nor
consistent with business necessity). The recommendation specificallc advises the client or whether
Occu -Med recommends that an employee should be returned to work or not returned to c ork.
Occu -Med's recommendation is outlined in each report and is determined by the evaltlation of the medical
information submitted in conjunction with the review of the essential functions or the job class.
The aforementioned qualifications are explained in each report along with the specifics or the case, For
example, sometimes the recommendation is that the employ ee be retained in or returned to the job o ih
work accommodations or restrictions. In this case, Occu -Med will provide the requested restrictions or
accommodations to the client, and the client must then identify the neeessar) ac ommodal!ons or
restrictions that are reasonable, if am)'. Thus, the City's obligation to reasonablc accommodation or the
employee is met. .lob assessment is completed and the employee can be returned to pork in the same
Job it the recommended accommodations are indeed reasonable.
In he event that the restrictions or accommodations aren't reasonahle, the client must then determine if an
_.,..,
Occu Med
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City of Santa Ann Response to Request for Proposal (RFP) Medical Scrvices Review 1 2/9/15
alternate job, for which the emp]o)ee is otherwise qualified (retains the necessar) knowledge, ski IIsand
abilities), exists and is presently eacant, allowing, the err plo)ec to return to work with the City under a
news ,job title. If alternalk ejob placement is not available, the client now has legally defensible
documentation tojustif) that the proposed accommodations are unreasonable. Occu -Med's report (Mcd-
Lcgal Anal)sis) integrates the functional limitations of the empim cc and the legal and practical
ramifications regarding the agency's ability to accommodate the employee's restrictions or
the egall) appropriate path for terminating the employee. Occu -Med considers all the relevant factors or
the case before rendering a Inedlcall) appropriate and legally defenslble)ob sultablht) recommendation.
In cases where the employee is unresponsive to Oceu -Med's correspondence a report documenting the
attempts to contact the employee and the uvploycc s failure to engage in the reasonable accommodation
process will be provided to the Cit) . With the City's apprm at, a Notification of Medical Disqualification
(Failure to Engage in the Reasonable Accommodation Process) letter M I I be sent to explain to the
employee that his or her lack Of response to the Individualized Assessment /Reasonable Accommodation
1 invimtion constitutes his or her failure to engage in the reasonable accommodation process. This letter
1 ma) also be used in the case that the employee's medical condition is a contraindication to job placement
and no reasonable accommodation could be made. Occu -Med's IRTW Report and recommendation will
allow the Cit) to make an informed, legally defensible decision as to whether or not an employee should
1 be returned to work.
I
E. Ocea °VAX
Occu -VAX is the scheduling and coordination, immunization record management and the on -going
management of all immunization and chemoprophylasis treatments for applicants and employees forjobs.
This service. includes an individualized evaluation of each applicant / employee to assess the
appropriateness and necessity for administering the immunization and chemoprophylaeis treatments
outlined in the specific Occu -VAX Profile prior to and, when appropriate, during employment.
Schp(lujima.lci Coordil)atioltl: Upon completion of the medical evaluation orconcurrentl) by
requirement or request from a designated City employee, Occu -Med Mil promptly contact applicants/
employees to: a,) assess the appropriateness and necessity for receiving inimuniaition and
chemoproph)inxis treatments, and b) schedule and coordinate [lie administration of those iinnuuiization
and chonioproph) la -xis treatments deemed appropriate and necessary prior to and during employ tnent.
to i Occu -Med
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City of Santa Ana Response to Request for Proposal (RFP) Medical Services Renew 1 219115
fmmunization Recir d N um 2ement: Applicants and employees will be given till immunization record
(documentation of hmnunization histor) ) upon completion of: a) initial administration of immunization
and chemoprophyiaxis treatments; or b) an assessment concluding that no immunization or
chemoprophylasis treatments are necessary. Immunization records for all applicants and employees
evaluated will be maintained electronical ly by Occu -Med. In the event an applicant for emplopec
declines an immunization Occu -Mad Will obtain the appropriate declination from the individual.
013, -Going Immunization Mani 2 ement: All immunization and chenoprophylasis treatments
recommended by NFPA, POST or the CDC a °ill be managed by OCCLI -Mad. This service includes
tracking to assure Compliance With the CDC %in addition to other applicable guidelines; notification of
employees and designated supervisory personnel ofall periodic follow-ups associated with immunization
and chemoprophyla.eis treatments; and, upon request, preparation and provision of customized tracking
reports documenting an\ aspect of the immunization and chemoprophylazis treatment program.
Occu -VAX is a dynamic service that any employer can access, from including a Hepatitis B Titer as part
of a pre - placement evaluation so that Hepatitis immunity can be immediately documented, or providing
on -site flu immunizations during the flu season. Should the City elect to incorporate Occu -VAX a medical
records management fee Would be applied.
OSHA Respirator Medical Evaluation Questionnaire rei iecc pursuant to CCR Title 8 § 5144.
OCCU -Med will administer OSHA Respirator Medical Evaluation Questionnaire pursuant to CCR Title 8
5144 to the applicant once the referral is received. Occu -Med can either use the City's form, or the
Ca]/OSHA fornn, These forms will be provided to the applicant electronically. Once returned to
OCCU -Mad the OSHA Respirator Medical Evaluation Questionnaire is reviewed by one of our physicians
or other licensed health care professional(Pf.HCP). When necessary, the applicant or employee \x
undergo a Pulmonary Function 'rest Occu -Med requires that three (3) blows be taken with the best result
becoming the medical record.
t Additional Annual Physicals
1
1 Based on coordination �v ith the City Occu -Med is able to prop ide those physical and associated medical
1 csam components as well: l'hese physicals would be scheduled and coordinated much the same way as
1 described in the Pre - Employment Physical Exam section of the document. OCCU -Med and the City WMild
t need to coordinate on the appropriate reporting channel for results in order to ensure only information that
1
r
17 1 oecu Med
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City of Santa Ana Response to Request for Proposal (UP) Medical Services Reviexv 1 2/9/13
is,job related and is consistent with business necessity will be shared kith the City. OCCa -MCCI is
prepared to expertly advise the City on the matter.
F. MILLING AND REPORTING
Occu -Med maintains a database of all exams that we rea ien', Occu -Med NN ill provide the City with a
quarterly report documenting the results of our work, if requested. Clinic performance reports
documenting accuracy and turnaround times for exams Lire also available to our clients upon request.
OCCU -Med will work with the City to establish [fiat speeiCie information the City- wishes to receive in
each report (see APPENDIX C]).
OCCU -Med has completed the City's Price Schedule and it is included in Occu -Med's proposal in the
appropriate location as directed by the City's REP. We have also included a supplemental page with
itemized fees associated with the requested services by the City.
i
EXAMQA Report Pee
I Our EXAMQA services Consists Of our customary review fee which includes the f'ollotving:
a
• Scheduling- of each medical exam
• Tracking each medical exam for applicant/employee attendance
• Harvesting all medical exam results from the clinic
• OCCa -Med Medical Network allowing City applicants to be seen anywhere in the United States
• ReN ievN and evaluation of completed medical examinations with results sent to you on the same
day that the exam is received
• Written reports for each review undertaken for each applicant
• Employ ment Agreements for an) employees placed with accommodations
• Additional reviews for applicants with medical or physical conditions requiring further testing or
submission of additional information
• Explanation (by telephone and by letter) to prospectiN c employees of additional medical
information necessary forjobelcurance
• Submission of ]",all) defensible hiring recommendations
• Assistance iN °ith reasonable accommodation recommendations
• Consultation relative to pre - placement, return -to -work, and fimess- For -duu issues
RDQA services
t3 i Occu•Med
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I City of Santa Ana Response to Request for Proposal (RFP) Medical Sen ices Review 2/9/15
r
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Assurance of excelIcut clinic performance issues, as needed
Periodic reports documenting the results of Occu -Med's [cork
QA' fees that the City would pay directly to the medical clinic, but Without all the hassle of dealing with
"MEDICAL BILLING INVOICES" OCCU -Mcd began its Clinic Bill Review service in 2006 as part of its
service to ITT, a company charged With deploying employees to Iraq, Kuwait, Qatar and Afghanistan for
carious major federal projects in that region. We have evaluated more over 100,000 clinic invoices for
pre - placement exams over this span of time and have been absolutely appalled at our findines: a) more
than 92% of these clinic invoices were initially submitted with inaccuracies (wrong charges for tests not
performed, charges for unnecessary testing performed, duplicate billings): and b) much worse is the fact
that nearly all of the incorrect im oices were inaccurate in favor of the clinic,
Occu -Med requires the submission of an accurate invoice for paN Trial. Which point we immediately
submit payment to the clinic. We submit our invoice to the City as a single fee (as negotiated) for an
exam — as the City's request our my oice will also include it list of itemized charges, however, the charges
will always add up to the pre - agreed negotiated fee, Clients have informed as that this "bill review"
service alone has literally saved days of staff time. Another client, upon learning of this billing trend,
audited the previous year's invoices and was able to obtain a refund or more than $3,000 for exams
performed.
On the first day ofeach month, OCCU -Med will submit an invoice to the City for the prior month's
medical services and examinations, Our invoices will be itemized by the date of service, name of person
examined, type of physical pert'ornted, itemized charges for each type of physical (if applicable), a
subtotal for each person examined, and a total ofcharges for the month being billed.
Our knowledge of the precise medical exam components that are of value for each specificjob class
(eliminating useless, improper and overly expensive medical tests),out- ability to negotiate lair and
reasonable charges from providers for medical exams. our national buying poorer for laborautr) services
(blood chemistry panels and wine drug screens), and our careful auditing or clinic and laboratory charges
allow us to offer a vastly expanded array of services to Our Clients for fees typically charged fly their
medical provider far just the medical examination and laboratory charges.
OCCU -Med Will in -tit be able to su bin it clear Lind strauigh I forwa rd month invoices to the Cit) (see
APPENDIX B). This stands in contrast to the amorphous and Often incorrect invoices ty pica lly submitted
T-IK
19 t Occu -Med
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City of Santa Ana Response to 12uluCSt for Proposal ( RFP) Medical Services Review i 2/9)15
b) clinics.
Occu -Med has completed the City's "Exhib—it C PROPOSERS CERTIFICATION and PROPOSAL. ITEM
PRICING ". Pursuant to the City's respoosCS to questions posed dated .lanuary 23, 2014 Occu -Med is
Providing an additional sheet as part of our fee schudulo with individual fine item fees for each medical
exam services requested.
INSURANCE
Oceu -Med agrees to provide the necessary insurance infcnmation to the City upon award oi'the Contact
in accordance with SECTION 5 on page 18 of the City's RF'P.
Thank }'ou For the opporumity to Participate in the Cit} of Santa Ana's RFP. we look forward to hearing
from \011.
ly Submitted By:
Director, Global Business ScrN ices
Occu- Med - _. .. ..
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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 with all 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 I COST PER I ESTIMATED
1i
See Attached Exhibit C Supplemental Fee Schedule
Occu -vied Ltd. 559,435.2800 Fax: 559.435.7200
LEGAL NAME OF COMPANY PHONE AND FAX NUMBERS
2121 West Bullard Avenue Fresno, CA 93711
BUSINESS ADDRESS
52- 2333519
FEDERAL ID NUMBER (IF APPLICABLE) 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.
Medical Services Review — January 12, 2015
Page 23
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a.
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V.
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ra.
ADDITIONAL INSURED ENDORSEMENT
Insurance Company
This endorsement modifies such insurance as is afforded by the provisions of Policy
# relating to the following:
1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California
92702; its officers, employees, agents and volunteers 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
canceled, 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 92702.
(Completion of the following, including countersignature, is required to make this
endorsement effective.)
Effective , this endorsement form as a part of
Policy #
Issued to
Named Insured
Date:
Countersigned by
Authorized Representative of Insurer
Or Insurance Agent
12
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