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CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
From:H. Doug ChandZetc Subject: Agtceemewt with San Bennandino Indui5tAuae
Ch,ie6 BxamineA Medi.cat C.e i nic to pnovide med.icat 6 eAvicez
Dept: Civ.%e Setcvice ion City
Augu,6t 1, 1996 opy
Synopsis of Previous Council action:
On Juty 10, 1996, the Counc it approved an agreement (RezoZut%on 95-233) bon
San Bennandino Ind sttiae MedicaZ Cti.nic to conduct pre-employment physicat
examinati.onz bon the City.
Recommended motion:
Adopt Ru o&tion
/ y�94J
Signature
Contact person: H. Doug Chand.PPh Phone: 5408
Supporting data attached: Ward:
FUNDING REQUIREMENTS: Amount: Source: -
Finance-
Council Notes:
Gontinued to 7 �7
75.0252 Agenda Item No.
CITY OF SAN BERNARDINO - REQUEST FOR COUNCIL ACTION
STAFF REPORT
San Bernardino Industrial Medical Clinic's agreement with the City
to provide physical examinations for the City has been in effect
since January 1, 1994.
The agreement covering the period August 1, 1996 through July 31,
1997, for San Bernardino Industrial Medical Clinic to provide
physical examinations for the City is attached. This agreement
represents no increase in cost to the City.
75-0264
1 RESOLUTION NO.
2 RESOLUTION OF THE CITY OF SAN BERNARDINO AUTHORIZING THE
EXECUTION OF AGREEMENT WITH SAN BERNARDINO INDUSTRIAL MEDICAL
3 CLINIC, RELATING TO MEDICAL SERVICES.
4 BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL OF THE
CITY OF SAN BERNARDINO AS FOLLOWS:
5
6 SECTION 1. The Mayor of the City of San Bernardino is
7 hereby authorized and directed to execute on behalf of said
8 City an agreement with San Bernardino Industrial Medical
9 Clinic for the purpose of conducting medical services for the
10 City, copy of which is attached hereto, marked Exhibit "A",
11 and incorporated herein by reference as fully as though set
12 forth at length. This agreement is effective August 1, 1996
13 and terminates on July 31, 1997.
14 SECTION 2. This agreement shall not take affect until
15 fully signed and executed by all parties. The City shall not
16 be obligated hereunder unless and until the Agreement is fully
17 executed and no oral agreement relating thereto shall be
18 implied or authorized.
SECTION 3. The authorization to execute the above
19
20 referenced agreement is rescinded if the parties to the
21 agreement fail to execute it within sixty (60) days of the
passage of this resolution.
22
23 I HEREBY CERTIFY that the foregoing resolution was duly
24 adopted by the Mayor and Common Council of the City of San
25 Bernardino at a meeting thereof, held on the
26 day of , 1996, by the following vote, to wit:
27
28 ��
1 RESOLUTION TO EXECUTE AN AGREEMENT WITH SAN BERNARDINO
INDUSTRIAL MEDICAL CLINIC RELATING TO MEDICAL SERVICES.
2
3 COUNCIL MEMBERS: AYES NAYS ABSTAIN ABSENT
4 NEGRETE
5 CURLIN
6 ARIAS
7 OBERHELMAN
8 DEVLIN
9 ANDERSON
10 MILLER
11
12 CITY CLERK
13
14 The foregoing resolution is hereby approved this
15 day of , 1996.
16
17
18 Tom Minor, Mayor
19 City of San Bernardino
20
Approved as to
21 form and legal content:
22
JAMES F. PENMAN
23 City Attorney
24
25
By:
26
27
28 2
1 EXHIBIT A
2 AGREEMENT
3 THIS AGREEMENT is made and entered into at San Bernardino
4 California, this day of , 1996, by and
5 between the CITY OF SAN BERNARDINO, a municipal corporation
6 hereinafter called "CITY" , and SAN BERNARDINO INDUSTRIAL
7 MEDICAL CLINIC, hereinafter called "Medical Clinic".
8 The parties agree as follows:
9 1. Services. Upon request and referral by City,
10 Medical Clinic 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
28
I examinee is received by Medical Clinic which authorizes the
2 release to the City of more extensive medical information.
3 2. Payment - Class II and III physicals. City shall
4 pay Physician $30. 00 for each person that City refers for a
5 pre-employment physical examination and evaluation. Said
6 physical examination shall specifically include, but not be
7 limited to, the items listed on Exhibit A, except as to those
8 items listed as "optional", or for which a stated additional
9 charge follows. Any item designated as "optional" shall mean
10 optional at the instance of City, and City shall pay Medical
11 Clinic for such optional services as may be required by the
12 City as follows: Department of Motor Vehicle license exam,
13 $30. 00 in addition to regular physical exam fee if both exams
14 are conducted; three view back x-ray, $30. 00; chest x-ray,
15 $25.00; flexibility and mobility tests, $15. 00; chemical panel
16 (LDH, SGOT, Bilirubin) $23 . 00; tuberculin skin tests, $10. 00;
17 electrocardiogram, $25. 00; drug screening for general abuse
18 drugs, $31. 00. Class I physicals - City shall pay Medical
19 Clinic $180. 00 for each person that City refers for a pre-
20 employment physical examination and evaluation. Said
21 examination shall specifically include, but not limited to,
22 the items listed on Exhibit A, except as to those items listed
23 as "optional", or for which a stated additional charge
24 follows. Any item designated as "optional" shall mean
25 optional at the instance of City, and City shall pay Medical
26 Clinic as follows: Steroid Evaluation Drug Screen Panel,
27 $150.00; Standing EKG, $20.00.
2
28
1 3 . Report and Recommendation. Following each
2 completed Class II and III examination a written report and
3 recommendation including significant findings and limitations
4 shall be prepared by Medical Clinic in the form set forth at
5 1(d) above and shall be forwarded to City within three days of
6 completion of the examination. Class I physical examinations
7 shall be forwarded to City within seven days of completion of
8 the examination. When the report reflects "normal" in an area
9 of examination, the statement shall mean that all applicable
10 items to be reviewed or examined have been so reviewed or
11 examined and that no significant adverse findings or
12 limitations were discovered.
13 4 . Additional Duties and Responsibilities. Medical Clinic
14 shall specifically assume the following additional duties and
15 responsibilities at a price to be agreed upon in advance of
16 such services by the parties.
17 (a) Appeals. In the event an unsuccessful
18 applicant appeals his or her rejection to the Civil Service
19 Board, Medical Clinic shall re-examine and re-evaluate the
20 appellant and provide information, in person or by
21 comprehensive narrative report, to the Civil Service Board
22 about the appellant's present medical limitations.
23 (b) Modifying guidelines. City may require expert
24 medical advice and consultation (including research results
25 and recommendations) on occasion for determining new, or
26
27 3
28
I revising existing, medical guidelines or changes in medical
2 procedures and examinations for future specific needs.
3 (c) Current employees. Medical Clinic shall
4 examine current employees with problematic medical symptoms or
5 conditions at City referral to determine if the employees are
6 physically able to safely perform their duties.
7
8 5. Billing. Medical Clinic shall bill City monthly and
9 said statement shall include the names of the persons examined
10 and the dates of the examinations. City will accept charges
11 only for those services first requested by City.
12 6. Equipment and Personnel. Medical Clinic hereby
13 agrees to have equipment and personnel for back-up and
14 emergencies to assure prompt scheduling of medical
15 examinations. Medical Clinic shall conduct any examinations
16 or testing within five working days of City's request for
17 scheduling the exams or tests. Medical Clinic shall designate
18 a competent physician or group of physicians to perform all
19 obligations pursuant to and in accordance with the terms of
20 this agreement in the event Physician is temporarily
21 unavailable to render services required. Medical Clinic
22 hereby covenants that any such physician or group of
23 physicians shall be competent with respect to the specific
24 tasks to be performed.
25 7. Assignment. This agreement may not be assigned by
26 either party hereto.
27
28 4
1 8. Hold harmless. Medical Clinic hereby agrees to, and
2 shall hold City, its elective and appointive boards,
3 commissions, officers, agents and employees harmless from any
4 liability for damage or claims for damage for personal injury,
5 including death, as well as for claims for property damage
6 which may arise from Medical Clinic's operations and
7 activities under this agreement, whether such operations and
8 activities be by Medical Clinic or by any one or more persons
9 directly or indirectly employed by or acting as agent for
10 Medical Clinic. Medical Clinic agrees to and shall defend
11 City and its elective and appointive boards, commissions,
12 officers, agents and employees from any suits or actions at
13 law or in equity for damages caused, or alleged to have been
14 caused, by reason of any of Medical Clinic's operations or
15 acts or omissions and activities hereunder.
16 9. Insurance. Medical Clinic shall be insured by an
17 insurance carrier acceptable to City against loss from public
18 liability arising from any operation or activity of the
19 Medical Clinic or employees in connection with the performance
20 of this agreement. Minimum coverage shall be one million
21 dollars combined single limit liability, to include medical
22 malpractice insurance. A copy of the policy of insurance
23 shall be filed with the Risk Management Division of City and
24 shall name the City of San Bernardino as an additional
25 insured. Said policy shall specify that the policy may not be
26 terminated, altered or cancelled without thirty (30) days
27 prior written notice to the City by the insurance company.
28 5
1 10. Workers' compensation. Medical Clinic's employees
2 shall be covered by workers' compensation insurance in an
3 amount and form to meet all applicable requirements of the
4 Labor Code of the State of California and which specifically
5 covers all persons providing services on behalf of Medical
6 Clinic and all risks to such persons under this agreement.
7 11. Term. This agreement shall be effective as of
8 the date of execution by City, and shall terminate July 31,
9 1997.
10 12 . Right of Termination. City and Medical Clinic shall
11 have the right to terminate this agreement at any time by the
12 giving of thirty days advance written notice to the other
13 party.
14 13. Notices. All notices hereunder shall be by
15 certified mail, postage prepaid, addressed as follows:
16 Civil Service Department San Bernardino
Chief Examiner Industrial Medical
17 300 N. "D" Street Clinic - Suite 108
San Bernardino, CA 92418 599 Inland Center Dr.
18 San Bernardino, CA 92408
19 14. Independent Contractor. Medical Clinic shall act as
20 an independent contractor in the performance of services
21 provided under this agreement and shall furnish such services
22 in Medical Clinic's own manner and methods and in no respect
23 be considered an agent or employee of City.
24 15. Entire Agreement. This agreement represents the
25 entire agreement between the parties and any amendments and/or
26 addenda shall be made in writing between the parties and
27 attached to this agreement.
28 6
1 AGREEMENT WITH SAN BERNARDINO INDUSTRIAL MEDICAL CLINIC,
RELATING TO MEDICAL SERVICES.
2
3 IN WITNESS WHEREOF, this agreement has been executed by
4 the parties effective as the date and year first above
5 written.
6 CITY OF SAN BERNARDINO, a
Municipal Corporation of
7 the State of California
8 ATTEST:
BY
9 Tom Minor, Mayor
10 City Clerk
11
Approved As to Form
12 and Legal Content.
Dr. Seymour Rosenblum
13 Primary Officer
San Bernardino Industrial
14 Medical Clinic
James F. Penman
15 City ,Attorney
16
BY:
17
18 /f
19 "\
20
21 "
22 "
23 "
24 "
25 "
26 "
27 "
28 7
I GROUP I MEDICAL EXAMINATION EXHIBIT A
2 GROUP I: Employees in the classifications of Police and Fire
Sworn employees and Police and Fire Dispatchers.
3 1. Personal and family health history questionnaire review.
4 2. Complete physical examination including:
Height
5 Weight
Blood Pressure
6 Pulse (before and after exercise)
Eyes (field of vision, extra ocular movements, pupils,
7 fundi)
Ears: tympanic membrane, wax
8 Nose, mouth, throat, dental hygiene
9 Neck
Chest
10 Heart
Lungs
Abdomen & Viscera - liver, kidneys, spleen
11 External genitalia (men) and hernia check (all)
Skin
12 Spine
Extremities
13 Lymph nodes
14 Nervous system
3. Laboratory studies:
15 Urinalysis: Sugar and Albumin
16 Hematology: Lipid Panel
4. Radiological Studies:
17 Lumbar Spine X-Rays (Sworn employees - 5 views)
18 Chest X-Ray (Dispatchers-ONLY with history of smoking)
19 5. Drug Screening for general abuse of drugs - GCMS
confirmation on all positive screens. Steroid Evaluation
20 Drug Panel (Sworn employees - optional)
21 6. Mobility and Flexibility tests (includes grip strength,
drawer sign, etc. )
22 7. Treadmill EKG where history or other tests suggest
23 problems (optional)
Standing EKG (Sworn employees only. Optional subject to
24 other test results. )
25 8. Pre-Employment TB testing
26 9. Written report of findings by physician within seven days
of completion of the examination.
27
28
I GROUP II MEDICAL EXAMINATION
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
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.
6 1. Personal and family health history questionnaire review.
7 2 . Complete physical examination including:
Height
8 Weight
Blood pressure
9 Pulse before and after exercise
Eyes: Field of vision, extra ocular movements, pupils,
fundi
10 Ears: Tympanic membrane, wax
11 Nose, mouth, throat, dental hygiene
Neck
12 Chest
Heart
13 Lungs
Abdomen -Liver, Spleen
14 External genitalia (men) and hernia check (all)
Skin
Spine
15 Extremities
16 Lymph nodes
Nervous system
17 (NOTE: Any abnormalities, i.e. , umbilical hernia, surgical
scars, etc. , must be noted by the physician. )
18 3. Eye test: (Corrected & Uncorrected) Near and Distant
19 Vision, Peripheral and Color Vision. (Use of Titmus II
testing equipment or its equivalent is required. )
20 4 . Hearing test: Audiometric testing using a PureTone
21 Audiometer and Soundproof Booth. Testing levels of 500,
1000, 2000, 3000, 4000, 6000 Hz.
22 5. Radiological studies: Two view lumbar spine x-ray
23 6. Laboratory studies:
24 Urinalysis: Sugar and Albumin
25 7. Mobility and flexibility tests (to include Jarmar Grip
Test)
26
27
28
1 8. Pre-employment Drug and Alcohol Screening - A screening
test for evidence of the use of the following drugs:
2 Marijuana, cocaine, Opiates, Amphetamines and
Phencyclidine. The following positions shall undergo pre-
3 employment substance screening:
4 Coach Operator
Heavy Equipment Operator
5 Park Maintenance Worker III
Motor Sweeper Operator
6 Refuse Operator I, II & III
Maintenance Worker II
7 Lead Maintenance Worker
8 9. DMV Exam - Conducted using the specific instructions
provided by DMV Form DL-51 for each category and any
9 deviation will be reported by the Physician to the Chief
10 Examiner.
10. Written report of findings by physician to the Chief
11 Examiner within seven (7) working days from day of
examination.
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
1 GROUP III EXAMINATIONS
2 GROUP III: Miscellaneous classifications - light to moderate
3 physical demands upon employees:
1. Review of personal data and family health history
4 questionnaire.
5 2. Proof of immunization record to examining physician with
copy to be held on file (Equivalent to State of
6 California requirements upon entry to education system) .
Positions in this category are the Recreation Series,
7 Food Handlers, Lifeguard Series, Teacher/Director,
Teacher and Teacher Aide.
8
3. Complete physical examination by physician including:
9 Height
Weight
10 Blood pressure
Pulse (before and after exercise)
11 Eyes: Field of vision, extra ocular movements, pupils,
f undi
12 Ears: Tympanic membrane, wax
Nose, mouth, throat, dental hygiene
13 Neck
Chest
14 Heart
Lungs
15 Abdomen - liver, spleen
External genitalia (men) and hernia check (all)
16 Skin
Spine
17 Extremities
Lymph nodes
18 Nervous system
19 (NOTE: Any abnormalities, i.e. , umbilical hernia, surgical
20 scars, etc. , must be noted by the physician. )
4. Eye test: (Corrected & Uncorrected) Near and distant
21 vision and color vision. (Use of Titmus II testing
equipment or its equivalent is required. )
Color vision
23 5. Hearing test: Audiometric testing using a PureTone
24 Audiometer and soundproof booth. (Testing levels of 500,
1000, 2000, 3000, 4000, 6000 Hz) .
25 6. Laboratory studies: Urinalysis Sugar and Albumin
26 7. T.B. test for employees involved in work in the close
27 proximity of children. Positions in this category are
the Food Handlers, Teacher/Director, Teacher, Teacher
28 Aide, Recreation series and Lifeguard series.
1 8. Proof of immunization record to examining physician with
copy to be held on file (Equivalent to State of
2 California requirements upon entry to education system) .
Positions in this category are the Recreation series,
3 Food Handlers, Lifeguard series, Teacher/Director,
Teacher and Teacher Aide.
4
9. Written report of findings by physician to the Chief
5 Examiner within seven (7) working days from day of
examination.
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
1 PRE-EMPLOYMENT MEDICAL EXAMINATION
FOR
2 EMPLOYEES IN THE POLICE AND
FIRE SAFETY CLASSIFICATIONS
3
1. Personal and family health history questionnaire review.
4
2 . Complete physical examination including:
5 Height
Weight
6 Blood Pressure
Pulse (before and after exercise)
7 Eyes (field of vision, extra ocular movements, pupils,
fundi. FOR POLICE SAFETY ONLY: appropriate examination
8 for visual acuity and color recognition ability using
Titmus II tester or its equivalent)
9 Ears (tympanic membrane, wax, and audio testing using an
audiometer and sound proof booth)
10 Nose, mouth, throat, dental hygiene
Neck
11 Chest
Heart
12 Lungs
Abdomen & Viscera - liver, kidneys, spleen
13 External genitalia (men) and hernia check (all)
Skin
14 Spine
Extremities
15 Lymph nodes
Nervous system
16
3 . Laboratory studies:
17 Urinalysis: Sugar and Albumin
18 Hematology: Lipid Panel
4. Radiological Studies:
19 Lumbar Spine X-Rays (5 views)
20 Chest X-Ray
5. Pre-employment Drug Screening - GCMS conformation on all
21 positive screens.
22 Steroid evaluation drug screen panel (optional)
6. Mobility and Flexibility tests (to include Jarmar grip
23 test. )
24 7. Standing EKG (optional - subject to other test results)
25 8. 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.