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. CIT.Y OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
From:H. Doug Chandler
Chief Examiner
Dept: Civil Service
ORIGINAL
Su~ect: Resolution of the City of San Bernardino
authorizing the execution of an Agreement with
Fox Occupational Medical Group relating to
medical services
Date: August 25, 1997
Synopsis of Previous Council action:
Since January,1994, the contract for conducting pre-employment medical services for the
City has been held by the Advantage Care Medical Group. This year the contract was put
out for bids and staff has selected the lowest bid from Fox Occupational Medical Group.
AUG 2 5 1997
Recommended motion:
Adopt Resolution
Contact person: H. Doug Chandler
Phone: 5008
Supporting data attached: Yes
Ward:
FUNDING REQUIREMENTS:
Amount: $24.000 est.
Source: (Acct. No.) 001-141- 5505
Acct. Descri tion Medical
Finance:
Council Notes:
Res 97- :J.. '6'7
'1/15/97
Agenda Item No. tl<i
75-0262
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. ~11:~ O~ SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
STAFF REPORT
The contract for conducting pre-employment medical services for the
City has been held by the Advantage Care Medical Group since
January, 1994, and was renewed in August, 1995 and August, 1996.
The contract consists of providing pre-employment medical screening
for three groups of employees: Group I: Safety Employees (Police
and Fire); Group II: Heavy Laborers, Skilled Trades, Heavy
Equipment Operators, Grounds Maintenance and Refuse COllection;
Group III: Miscellaneous classifications, Le., Clerical,
Engineers, Draftspersons, etc.
This year the contract was put out for bids and staff invited
thirteen health care providers to submit price proposals for the
contract. six providers, all from San Bernardino, responded with
written proposals:
PROVIDBR
Dewar Medical Group
Inland Health Organization
Highland Medical Center
Cornerstone Medical Group
Advantage Care Medical Group
Fox Occupational Medical Group-
TOTAL COST
$1,444.00
$802.00
$663.00
$327.00
$322.00
$293.00
Fox Occupational Medical Center submitted the lowest bid of
$293.00, the total cost for providing the three classes of pre-
employment medical evaluations - (Group I: $146; Group II: .$81;
Group III: $66).
The contract will become effective October 1, 1997, and terminate
on July 31, 1998.
75~0264
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1 EXHIBIT A
2 AGREEMENT
3 THIS AGREEMENT is made and entered into at San Bernardino
4 California, this day of , 1997, by and
5 between the CITY OF SAN BERNARDINO, a municipal corporation
6 hereinafter called "CITY" , and FOX OCCUPATIONAL MEDICAL
7 CENTER, hereinafter called "Medical Center".
8 The parties agree as follows:
9 1. Services. Upon request and referral by City,
10 Medical Center shall conduct pre-employment physicals and
11 evaluations and provide other medical services for City. Such
12 services shall include, but not be limited to, the following:
13 (a) providing central coordination of medical data
14 and information related to pre-employment physicals and
15 evaluations for City;
16 (b) obtaining the medical history of and personally
17 examining and reviewing all medical tests pertaining to
18 persons referred by city in accordance with the specifics set
19 forth in Exhibit "A", attached hereto and incorporated herein
20 by reference;
21 (c) upon specific request of city, taking x-rays
22 and conducting other medical tests and providing City an
23 evaluation thereof; and
24 (d) providing City a summary and evaluation in
25 regards to exams conducted hereunder. Any such summary or
26 evaluation shall be in a form as permitted under California
27 Civil Code Section 56.10 unless a document signed by the
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1 examinee is received by Medical Center which authorizes the
2 release to the city of more extensive medical information.
3 2. Payment - Class I physicals - city shall pay Medical
4 Center $146.00 for each person that city refers for a pre-
5 employment physical examination and evaluation. Said
6 examination shall specifically include, but not be limited to,
7 the items listed on Exhibit A, except as to those items listed
8 as "optional", or for which a stated additional charge
9 follows. Any item designated as "optional" shall mean
10 optional at the instance of City, and City shall pay Medical
11 Center as follows: Steroid Evaluation Drug Screen Panel,
12 $18.00; standing EKG, $25.00. Class II physicals - City
13 shall pay Medical Center $81. 00 for each person that City
14 refers for a pre-employment physical examination and
15 evaluation. Said physical examination shall specifically
16 include, but not be limited to, the items listed on Exhibit A.
17 For Department of Motor Vehicle License Examinations, City
18 shall pay Medical Center $96.00, or $15.00 in addition to
19 regular physical exam fee if both exams are conducted. Class
20 III physicals - city shall pay Medical Center $66.00 for each
21 person that City refers for a pre-employment physical
22 examination and evaluation. Said physical examination shall
23 specifically include, but not be limited to, the items listed
24 on Exhibit A.
25 3. Report and Recommendation. Following each
26 completed Class II and III examination a written report and
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1 recommendation including significant findings and limitations
2 shall be prepared by Medical Center in the form set forth at
3 l(d) above and shall be forwarded to City within three days of
4 completion of the examination. Class I physical examinations
5 shall be forwarded to city within seven days of completion of
6 the examination. When the report reflects "normal" in an area
7 of examination, the statement shall mean that all applicable
8 items to be reviewed or examined have been so reviewed or
9 examined and that no significant adverse findings or
limitations were discovered.
4. Additional Duties and Responsibilities. Medical Center
shall specifically assume the following additional duties and
responsibilities at a price to be agreed upon in advance of
such services by the parties.
(a) Appeals. In the event an unsuccessful
applicant appeals his or her rejection to the civil Service
Board, Medical Center shall re-examine and re-evaluate the
appellant and provide information, in person or by
comprehensive narrative report, to the civil Service Board
about the appellant's present medical limitations.
(b) Modifying guidelines. City may require expert
medical advice and consultation (including research results
and recommendations) on occasion for determining new, or
revising existing, medical guidelines or changes in medical
25 procedures and examinations for future specific needs.
26 (c) Current employees. Medical Center shall
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1 examine current employees with problematic medical symptoms or
2 conditions at city referral to determine if the employees are
3 physically able to safely perform their duties.
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5. Billing. Medical Center shall bill City monthly and
said statement shall include the names of the persons examined
and the dates of the examinations. City will accept charges
only for those services first requested by City.
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6. Equipment and Personnel. Medical Center hereby
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agrees to have equipment and personnel for back-up and
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emergencies to assure prompt scheduling of medical
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examinations. Medical Center shall conduct any examinations
or testing within five working days of City's request for
scheduling the exams or tests. Medical Center shall designate
a competent physician or group of physicians to perform all
obligations pursuant to and in accordance with the terms of
this agreement in the event Medical Center is temporarily
unavailable to render services required. Medical Center
hereby covenants that any such physician or group of
physicians shall be competent with respect to the specific
tasks to be performed.
7. Assignment. This agreement may not be assigned by
either party hereto.
8. Hold harmless. Medical Center hereby agrees to, and
shall hold City, its elective and appointive boards,
commissions, officers, agents and employees harmless from any
liability for damage or claims for damage for personal injury,
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1 including death, as well as for claims for property damage
2 which may arise from Medical Center's operations and
3 activities under this agreement, whether such operations and
activities be by Medical Center or by anyone or more persons
directly or indirectly employed by or acting as agent for
Medical Center. Medical Center agrees to and shall defend
city and its elective and appointive boards, commissions,
officers, agents and employees from any suits or actions at
law or in equity for damages caused, or alleged to have been
caused, by reason of any of Medical Center's operations or
acts or omissions and activities hereunder.
9. Insurance. Medical Center shall be insured by an
insurance carrier acceptable to City against loss from public
liability arising from any operation or activity of the
Medical Center or employees in connection with the performance
of this agreement. Minimum coverage shall be one million
dollars combined single limit liability, to include medical
malpractice insurance. A copy of the policy of insurance
shall be filed with the Risk Management Division of City and
shall name the City of San Bernardino as an additional
insured. Said policy shall specify that the policy may not be
22 terminated, altered or cancelled without thirty (30) days
23 prior written notice to the City by the insurance company.
24 10. Workers' compensation. Medical Center's employees
25 shall be covered by workers' compensation insurance in an
26 amount and form to meet all applicable requirements of the
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2 covers all persons providing services on behalf of Medical
3 Center and all risks to such persons under this agreement.
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11. Term.
This agreement shall be effective as of
the date of execution by City, and shall terminate July 31,
1998.
12. Right of Termination. City and Medical Center shall
have the right to terminate this agreement at any time by the
giving of thirty days advance written notice to the other
party.
13. Notices. All notices hereunder shall be by
certified mail, postage prepaid, addressed as follows:
Civil service Department
Chief Examiner
300 N. "0" street
San Bernardino, CA 92418
Fox Occupational
Medical Center
suite 130
1375 Camino Real
San Bernardino, CA 92408
14. Independent Contractor. Medical Center shall act as
an independent contractor in the performance of services
provided under this agreement and shall furnish such services
in Medical Center's own manner and methods and in no respect
be considered an agent or employee of city.
15. Entire Agreement. This agreement represents the
entire agreement between the parties and any amendments and/or
23 addenda shall be made in writing between the parties and
24 attached to this agreement.
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1 AGREEMENT WITH FOX OCCUPATIONAL MEDICAL CENTER, RELATING TO
2 MEDICAL SERVICES.
3 IN WITNESS WHEREOF, this agreement has been executed by
4 the parties effective as the date and year first above
5 written.
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7
CITY OF SAN BERNARDINO, a
Municipal Corporation of
the State of California
8 ATTEST:
9
10 City Clerk
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12 Approved As to Form
and Legal Content.
BY
Tom Minor, Mayor
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Roger E. Fox
Owner & Medical Director
Fox Occupational Medical
Center
James F. Penman
15 city Attorney
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GROUP J: MEDJ:CAL BXAHJ:NATJ:ON
EXHIBIT A
2 GROUP I: Employees in the classifications of Police and Fire
3 Sworn employees.
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Personal and family health history questionnaire review.
Complete physical examination including:
Height
Weight
Blood Pressure
Pulse (before and after exercise)
Eyes (field of vision, extra ocular movements, pupils,
fundi. FOR POLICE SAFETY ONLY: appropriate examination
for visual acuity and color recognition ability using
Titmus II tester or its equivalent)
Ears (tympanic membrane, wax, and audio testing using an
audiometer and sound proof booth)
Nose, mouth, throat, dental hygiene
Neck
Chest
Heart
Lungs
Abdomen & Viscera - liver, kidneys, spleen
External genitalia (men) and hernia check (all)
Skin
Spine
Extremities
Lymph nodes
Nervous system
Laboratory studies:
Urinalysis: Sugar and Albumin
Hematology: Lipid Panel
Radiological Studies:
Lumbar Spine X-Rays (5 views)
Chest X-Ray
Pre-employment Drug screening - GCMS conformation on all
positive screens.
Steroid evaluation drug screen panel (optional)
Mobility and Flexibility tests (to include Jarmar grip
test. )
Standing EKG (optional - subject to other test results)
Pulmonary function/Spirometer
26 9. Pre-employment TB testing
27 10. Written report of findings by physician within seven (7)
28 working days from day of the examination.
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GROOP II IIBDlCAL BXAHlNATION
2 GROUP II: Employees for heavy labor, skilled trades, equipment
3 operation, refuse collection, and grounds maintenance
classifications. These jobs require one or more of the
4 following: lifting and/or carrying weights of more than 50
pounds: repetitive awkward motions of the trunk or the back:
5 frequent bending, squatting, climbing or prolonged standing.
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Personal and family health history questionnaire review.
Complete physical examination including:
Height
Weight
Blood pressure
Pulse before and after exercise
Eyes: Field of vision, extra ocular movements, pupils,
fundi
Tympanic membrane, wax
mouth, throat, dental hygiene
Ears:
Nose,
Neck
Chest
Heart
Lungs
Abdomen -Liver, Spleen
External genitalia (men) and hernia check (all)
Skin
Spine
Extremities
Lymph nodes
Nervous system
(NOTB: Any abnormalities, i.e., umbilical hernia, surgical
scars, etc., must be noted by the physician.)
3. Eye test: (Corrected & Uncorrected) Near and Distant
Vision, Peripheral and Color Vision. (Ose ot Titmus II
testing equipment or its equivalent is required.)
4. Hearing test: Audiometric testing using a PureTone
Audiometer and Soundproof Booth. Testing levels of 500,
1000, 2000, 3000, 4000, 6000 Hz.
5. Radiological studies: Two view lumbar spine x-ray
6.
Laboratory studies:
Urinalysis: Sugar and Albumin
Mobility and flexibility tests (to include Jarmar Grip
Test)
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Pre-employment Drug and Alcohol Screening - A screening
test for evidence of the use of the following drugs:
XarijulUla, cocaine, opiate., AIIlphet_ine. and
Phencyclidine. The following positions shall undergo pre-
employment substance screening:
Coach Operator
Heavy Equipment Operator
Park Maintenance Worker III
Motor Sweeper Operator
Refuse Operator I, II & III
Maintenance Worker II
Lead Maintenance Worker
DMV Exam - Conducted using the specific instructions
provided by DMV Form DL-51 for each category and any
deviation will be reported by the Physician to the Chief
Examiner.
written report of findings by physician to the Chief
Examiner within seven (7) working days from day of
examination.
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GROUP III BXAKlRATIONS
2 GROUP III: Miscellaneous classifications - light to moderate
3 physical demands upon employees:
Review of personal data and family health history
questionnaire.
Proof of immunization record to examining physician with
copy to be held on file (Equivalent to state of
California requirements upon entry to education system).
positions in this category are the Recreation Series,
Food Handlers, Lifeguard Series, Teacher/Director,
Teacher and Teacher Aide.
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Complete physical examination by physician including:
Height
Weight
Blood pressure
Pulse (before and after exercise)
Eyes: Field of vision, extra ocular movements, pupils,
fundi
Ears: Tympanic membrane, wax
Nose, mouth, throat, dental hygiene
Neck
Chest
Heart
Lungs
Abdomen - liver, spleen
External genitalia (men) and hernia check (all)
Skin
Spine
Extremities
Lymph nodes
Nervous system
(NOTB: Any abnormalities, i.e., umbilical hernia, surgical
scars, etc., must be noted by the physician.)
Eye test: (Corrected & Uncorrected) Near and
vision and color vision. (Use of Titmus II
equipment or its equivalent is required.)
Color vision
distant
testing
Hearing test: Audiometric testing using a PureTone
Audiometer and soundproof booth. (Testing levels of 500,
1000, 2000, 3000, 4000, 6000 Hz).
Laboratory studies: Urinalysis sugar and Albumin
T.B. test for employees involved in work in the close
proximity of children. Positions in this category are
the Food Handlers, Teacher/Director, Teacher, Teacher
Aide, Recreation series and Lifeguard series.
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Proof of immunization record to examining physician with
copy to be held on file (Equivalent to state of
California requirements upon entry to education system).
positions in this category are the Recreation series,
Food Handlers, Lifeguard series, Teacher/Director,
Teacher and Teacher Aide.
written report of findings
Examiner within seven (7)
examination.
by physician to the Chief
working days from day of