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HomeMy WebLinkAboutRFP - P1089 MEDICAL PROVIDER - WORKERS COMPENSATION (5)Wnapitki itrvc Sere tees 9-5rNi Msillti rrIMM ADDENDUM No 1 SPECIFICATIONS AND CONTRACT DOCUMENTS Description of RFP P1089 Medical Provider -Workers Compensation OPENING DATE 3 00 P M (Our Clock) October 29, 2007 To all prospective bidders under the specifications and contract documents described above, the following changes are hereby made REVISIONS: This is a joint proposal with the City of Fort Collins and Poudre School District Poudre School District will complete a separate agreement with the selE:cted vendors • Number of copies of the proposal to be submitted, seven (7) copies • PROPOSAL GUIDELINES Complete description of your facilities, including details on x-rays, audiogram, physical therapy procedures, drug and or alcohol testing, pharmacy services, etc Give the physical location of your facilities If your organization does not have a facility in Ft Collins, are you planning to open an office In the near future If so, when? If not, would you commit to opening an office in Ft Collins If you were awarded either the City contract OR the Poudre School District contract or both within SIX months' 11 Indicate how quickly an injured employee could be seen by a physician when making an initial appointment Indicate how an employee will receive treatment should they be injured during office hours and when your office is closed 12 Indicate time allotted for office visits Are Doctors scheduled to see patients every 10, 15 or 20 minutes? Indicate if you treat on a walk-in basis for Initial treatment or If an appointment is necessary If so, what is the average wait time? Indicate the average wait time beyond an injured employees scheduled appointment ADD 14 Indicate if you can provide drug and alcohol testing services If so, can you provide onsite random testing on a quarterly basis? Do you provide random selection for testing or do you use a third -party? If a third -party, what organization do you use? How do you handle after hours and reasonable suspicion testing? Are results available online through a secure website? 4 SCOPE OF WORK 10 Indicate how many of your physicians are Level II accredited Do you have other physician's or physician's assistants on staff That are not Level 11 accredited? /f so, indicated how many Please contact James B O'Neill, II, CPPO, FNIGP at (970) 221-6779 with any questions regarding this addendum RECEIPT OF THIS ADDENDUM MUST BE ACKNOWLEDGED BY A'WRITTEN STATEMENT ENCLOSED WITH THE BID/QUOTE STATING THAT THIS ADDENDUM HAS BEEN RECEIVED. 215 Nerth Mason tibctt • 2"" Floor • P 0 But 5Nt1 • Fort r011its, CO N0522-0590 • (970) 221-6775 • 1 is (970) 221-6707 nww Ic¢ot tom employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, personal representatives, successors and assigns of said parties 14 Indemnity/Insurance a The Service Provider agrees to indemnify and save harmless the City, its officers, agents and employees against and from any and all actions, suits, claims, demands or liability of any character whatsoever brought or asserted for injuries to or death of any person or persons, or damages to property arising out of, result from or occurring in connection with the performance of any service hereunder b The Service Provider shall take all necessary precautions in performing the work hereunder to prevent injury to persons and property c Without limiting any of the Service Provider's obligations hereunder, the Service Provider shall provide and maintain insurance coverage naming the City as an additional insured under this Agreement of the type and -with -the limits specified within Exhibit B, consisting of one (1) page, attached hereto and incorporated herein by this reference The Service Provider before commencing services hereunder, shall deliver to the City's Director of Purchasing and Risk Management, P O Box 580 Fort Collins, Colorado 80522 one copy of a certificate evidencing the insurance coverage required from an insurance company acceptable to the City 15 Entire Agreement This Agreement, along with all Exhibits and other documents incorporated herein, shall constitute the entire Agreement of the parties Covenants or representations not contained in this Agreement shall not be binding on the parties 16 Law/Severability The laws of the State of Colorado shall govern the construction interpretation, execution and enforcement of this Agreement In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not invalidate or render unenforceable any other provision of this Agreement 5 SA rev06/07 17 Prohibition Against Employing Illegal Aliens This paragraph shall apply to all Contractors whose performance of work under this Agreement does not involve the delivery of a specific end product other than reports that are merely incidental to the performance of said work Pursuant to Section 8-17 5-101, C R S , et seq , Contractor represents and agrees that a As of the date of this Agreement and 1 Contractor does not knowingly employ or contract with an illegal alien, 2 Contractor has participated or attempted to participate in the basic pilot employment verification program created in Public Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th Congress, as amended, administered by the United States Department of Homeland Security (the "Basic Pilot Program") in order to confirm the employment eligibility of all newly hired employees b Contractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement or knowingly enter into a contract with a subcontractor that knowingly employs or contracts with an illegal alien to perform work under this Agreement c Contractor shall continue to apply to participate in the Basic Pilot Program and shall in writing verify same every three (3) calendar months thereafter, until Contractor is accepted or the public contract for services has been completed, whichever is earlier The requirements of this section shall not be required or effective if the Basic Pilot Program is discontinued d Contractor is prohibited from using Basic Pilot Program procedures to undertake pre -employment screening of job applicants while this Agreement is being performed 6 SA rev06/07 e If Contractor obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Contractor shall 1 Notify such subcontractor and the City within three days that Contractor has actual knowledge that the subcontractor is employing or contracting with an illegal alien, and 2 Terminate the subcontract with the subcontractor if within three days of receiving the notice required pursuant to this section the subcontractor does not cease employing or contracting with the illegal alien, except that Contractor shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien f Contractor shall comply with any reasonable request by the Colorado Department of Labor and Employment (the "Department") made in the course of an investigation that the Department undertakes or is undertaking pursuant to the authority established in Subsection 8-17 5-102 (5), C R S g If Contractor violates any provision of this Agreement pertaining to the duties imposed by Subsection 8-17 5-102, C R S the City may terminate this Agreement If this Agreement is so terminated, Contractor shall be liable for actual and consequential damages to the City arising out of Contractor's violation of Subsection 8-17 5-102, C R S h The City will notify the Office of the Secretary of State if Contractor violates this provision of this Agreement and the City terminates the Agreement for such breach 18 Special Provisions [Optional] Special provisions or conditions relating to the services to be performed pursuant to this Agreement are set forth in Exhibit " ", consisting of ( ) pages, attached hereto and incorporated herein by this reference 7 SA rev06107 CITY OF FORT COLLINS, COLORADO a municipal corporation By James B O'Neill II, CPPO, FNIGP Director of Purchasing and Risk Management Date ATTEST City Clerk APPROVED AS TO FORM Assistant City Attorney By PRINT NAME CORPORATE PRESIDENT OR VICE PRESIDENT Date ATTEST CORPORATE SECRETARY (Corporate Seal) SA rev06/07 INSURANCE REQUIREMENTS 1 The Service Provider will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs Before commencing work under this bid, the Service Provider shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies, and containing substantially the following statement "The insurance evidenced by this Certificate will not be cancelled or materially altered, except after ten (10) days written notice has been received by the City of Fort Collins " In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement The City, its officers, agents and employees shall be named as additional insureds on the Service Provider's general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement 2 Insurance coverages shall be as follows A Workers' Compensation & Employer's Liability The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement Workers' Compensation insurance with statutory limits as required by Colorado law Employer's Liability insurance with limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee B Commercial General & Vehicle Liability The Service Provider shall maintain during the life of this Agreement such commercial general liability and automobile liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement Coverage for property damage shall be on a "broad form" basis The amount of insurance for each coverage, Commercial General and Vehicle, shall not be less than $500,000 combined single limits for bodily injury and property damage In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance EXHIBIT "B" INSURANCE REQUIREMENTS 1 The Service Provider will provide, from insurance companies acceptable to the City, the insurance coverage designated hereinafter and pay all costs Before commencing work under this bid, the Service Provider shall furnish the City with certificates of insurance showing the type, amount, class of operations covered, effective dates and date of expiration of policies, and containing substantially the following statement "The insurance evidenced by this Certificate will not be cancelled or materially altered, except after ten (10) days written notice has been received by the City of Fort Collins " In case of the breach of any provision of the Insurance Requirements, the City, at its option, may take out and maintain, at the expense of the Service Provider, such insurance as the City may deem proper and may deduct the cost of such insurance from any monies which may be due or become due the Service Provider under this Agreement The City, its officers, agents and employees shall be named as additional insureds on the Service Provider's general liability and automobile liability insurance policies for any claims arising out of work performed under this Agreement 2 Insurance coverages shall be as follows A Workers' Compensation & Employer's Liability The Service Provider shall maintain during the life of this Agreement for all of the Service Provider's employees engaged in work performed under this agreement -- --- 1 Workers' Compensation insurance with statutory limits as required by Colorado law 2 Employer's Liability insurance with limits of $100,000 per accident, $500,000 disease aggregate, and $100,000 disease each employee B Commercial General & Vehicle Liability The Service Provider shall maintain during the life of this Agreement such commercial general liability and automobile liability insurance as will provide coverage for damage claims of personal injury, including accidental death, as well as for claims for property damage, which may arise directly or indirectly from the performance of work under this Agreement Coverage for property damage shall be on a "broad form" basis The amount of insurance for each coverage, Commercial General and Vehicle, shall not be less than $500,000 combined single limits for bodily injury and property damage In the event any work is performed by a subcontractor, the Service Provider shall be responsible for any liability directly or indirectly arising out of the work performed under this Agreement by a subcontractor, which liability is not covered by the subcontractor's insurance 4ilm1mstrative 4ereiccs Yurett.iKUM" 1 5NMI .,^-- ,,,-" It - r ti _ tf1 REQUEST FOR PROPOSAL P1089 Medical Provider- Workers Compensation C'ity of Fort Collins The City of Fort Collins is seeking proposals from qualified medical facilities to provide medical treatment to City employees injured in the course of employment, pre -employment testing required by Risk Management, DOT testing, drug and or alcohol testing and other medical services as may be deemed beneficial to City employees Written proposals, five (5) will be received at the City of Fort Collins' Purchasing Division, 215 North Mason St , 2nd floor, Fort Collins, Colorado 80524 Proposals will be received before 3 00 p m (our clock), October 29, 2007 Proposal No P1089 If delivered, they are to be sent to 215 North Mason Street, 2nd Floor, Fort Collins, Colorado 80524 if mailed, the address is P O Box 580, Fort Collins, 80522-0580 Questions concerning the scope of the project should be directed to Project Manager Lance Murray (970)221-6807 Questions regarding proposals submittal or process should be directed to James B O'Neill, II, CPPO, FNIGP (970) 221-6779 A copy of the Proposal may be obtained as follows Download the Proposal/Bid from the BuySpeed Webpage, htdps //secure2 fcgov com/bso/login isp 2 Come by Purchasing at 215 North Mason St , 21d floor, Fort Collins, and request a copy of the Bid Sales ProhibitedlConflict of Interest No officer, employee, or member of City Council, shall have a financial interest in the sale to the City of any real or personal property, equipment, material, supplies or services where such officer or employee exercises directly or indirectly any decision -making authority concerning such sale or any supervisory authority over the services to be rendered This rule; also applies to subcontracts with the City Soliciting or accepting any gift, gratuity favor, entertainment, kickback or any items of monetary value from any person who has or is seeking to do business with the City of Fort Collins is prohibited Collusive or sham proposals Any proposal deemed to be collusive or a sham proposal will be rejected and reported to authorities as such Your authorized signature of this proposal assures that such proposal is genuine and is not a collusive or sham proposal The City of Fort Collins reserves the right to reject any and all proposals and to waive any irre903nties or informalities Sincerely, J m s B O'Neill II, CPPO, FNIGP Di e. for of Purchasing & Risk Management 215 Not th Mason Street • 2"" Hoor • P 0 Boa 580 • Fort Colhns, CO 80522-0580 • (970) 221-6715 • Fax (970) 221-6707 t+ww tceot com REQUEST FOR PROPOSAL P1089 Medical Provider- Workers Compensation BACKGROUND The City implemented a designated physician program in May 1986 to provide medical treatment for employees injured on the job Under the Colorado Workers' Compensation Act, (8-51-110(5)(a), the employer has the right to first choice of physician(s) when an employee is injured on the job Effective January 1, 1989, the City commenced a workers' compensation self-insurance program A local third party administrator manages claims and processes payments Effective January 1, 2008, Colorado House Bill 07-1176 will take effect requiring employers to provide employees two options of medical providers when an employee is injured on the job This service is currently being provided by Poudre Valley Hospital's Occupational Health Services The City operates and maintains an effective return to work program It is the City's intent that this contract be for a five (5) year period Fees will be reviewed and negotiated on an annual basis ninety (90) days prior to each annual expiration date PROPOSAL GUIDELINES 1 Qualified forms interested in the work described in this request should submit a minimum of the following information to the City 2 Qualifications of your firm and staff '3 Copy of fee schedule, including hourly fee for hearing testimony Are these fees at or below the Colorado Fee Schedule for workers' compensation cases? Do you discount bills for prompt payment? 4 Complete description of your facilities, including details on x-rays, audiogram, physical therapy procedures, drug and or alcohol testing, pharmacy services, etc 5 Explanation of how your firm will meet requested scope of work 6 References from other firms for whom you provide a similar service 7 A list of referral specialist that may be utilized by your firm Indurate when a specialist will be utilized and typical time frame for referrals 8 Indicate your treatment protocol when an employee claims mental disability as a result of a physical injury 9 Indicate the percentage of your business that pertains to the treatment and management of occupational injuries 10 If an employee is referred to a specialist outside of your firm, please indicate how you will still maintain control 11 Indicate how an employee will receive treatment should they be injured during office hours and when your office is closed 12 Indicate tirne allotted for office visits Are Doctors scheduled to see patients every 10, 15 or 20 minutes? 13 Indicate how impairment ratings are performed and who is authorized to perform SCOPE OF WORK 1 Provide appropriate medical care and case management at a minimum of five (5) days a week from 8 00 a m to 5 00 p m , for City of Fort Collins employees that have injuries or illnesses alleged to have occurred as a result of their employment 2 Maintain accurate medical records for every City employee receiving medical care Individual patient records and reporting systems necessary to carry out program administrative, planning, and legal requirements will be established and maintained 3 Notify Risk. Management after medical treatment is rendered The report will include information on the accident/exposure, work restrictions, and prognosis for return to work This information should be transmitted to the city's electronic mail system or Risk Management fax 4 Notify Risk Management for approval prior to referral of employee from your facility to another physician, or upon admission to a hospital or other facility All information for on -going treatment shall be sent promptly to the receiving physician, hospital or other facility 5 Provide employee with written "status" report outlining work restrictions, if any, for every visit Fi Provide a written report within TWO (2) days of initial treatment to claim administrator 7 Provide city employees with copies of all written communications regarding medical treatment 8 Provide specialty services as requested such as physical examinations, audiograms, x- rays, EKG's, immunizations, physical therapy, drug and alcohol testing, DOT physicals, pre -employment physicals and other medical services as may be deemed beneficial to City employees and the employer 9 Be familiar with Workers' Compensation laws and provide hearing testimony when needed 10 City employees shall be treated only by Level 11 accredited physicians 11 Cooperate with the City's claim administrator and risk management staff in submitting information at their request as needed in a timely manner 12 Participate in consultations with employer and claim administrator as requested to discuss specific cases and procedures Meetings are held each month with the current medical provider 13 Provide a written medical treatment plan when requested 14 Conduct return to work (fitness for duty) examinations as requested by the City's Risk Management or Human Resources department, and provide appropriate feedback to staff regarding employees' work restrictions vis-a-vis the employees' job duties 15 Assess work relatedness upon initial employee visit to diminish the possibility of fraudulent claims 16 Employees may be given a "Patient Satisfaction Survey" upon completion of medical services or when they reach MMI REVIEW AND ASSESSMENT Professional firms will be evaluated on the following criteria These criteria will be the basis for review of the written proposals and interview session The rating scale shall be from 1 to 5, with 1 being a poor rating, 3 being an average rating, and 5 being an outstanding rating WEIGHTING QUALIFICATION STANDARD FACTOR 2 C Scope of Proposal Does the proposal show an understanding of the project objective, methodology to be used and results that are desired? 20 Assigned Personnel Do the persons who will be working on the project have the necessary skills? Are sufficient people of the requisite skills assigned? 1 0 Availability Existing workload and staff 1 0 Motivation Is the firm interested and are they capable of doing the work in the required time frame? 20 Cost and Are any incentives offered? Usual and customary Work Hours charges 20 Firm Capability Does the firm have the support capabilities the assigned personnel require? Has the firm done previous projects of this type and scope? Reference evaluation (Top Ranked Firm) The Project Manager will check references using the following criteria The evaluation rankings will be labeled Satisfactory/Unsatisfactory QUALIFICATION STANDARD Overall Performance Are you pleased with the services provided? Thoroughness Does the provider follow through with cases, keeping you informed of status? Knowledge of "Colorado Workers Compensation" Is there an understanding of State Workers Compensation procedures? Record keeping Is record keeping timely and efficient? Specific contract iegwrements Is the provider able to provide specific needs or are all services from the "mold"? SERVICES AGREEMENT THIS AGREEMENT made and entered into the day and year set forth below by and between THE CITY OF FORT COLLINS, COLORADO, a Municipal Corporation, hereinafter referred to as the "City" and , hereinafter referred to as "Service Provider" WITNESSETH_ In consideration of the mutual covenants and obligations herein expressed, it is agreed by and between the parties hereto as follows 1 Scope of Services The Service Provider agrees to provide services in accordance with the scope of services attached hereto as Exhibit "A", consisting of pages and incorporated herein by this reference 2 Contract Period This Agreement shall commence , and shall continue in full force and effect until , unless sooner terminated as herein provided 3 Deli If either party is prevented in whole or in part from performing its obligations by unforeseeable causes beyond its reasonable control and without its fault or negligence, then the party so prevented shall be excused from whatever performance is prevented by such cause To the extent that the performance is actually prevented, the Service Provider must provide written notice to the City of such condition within fifteen (15) days from the onset of such condition 4 Eaily Termination by City/Notice Notwithstanding the time periods contained herein, the City may terminate this Agreement at any time without cause by providing written notice of termination to the Service Provider Such notice shall be delivered at least fifteen (15) days prior to the termination date contained in said notice unless otherwise agreed in writing by the parties All notices provided under this Agreement shall be effective when mailed, postage prepaid and sent to the following addresses City - City of Fort Collins Attn Purchasing PO Box 580 Service Provider- 2 SA rev06/07 Fort Collins, CO 80522 In the event of early termination by the City, the Service Provider shall be paid for services rendered to the date of termination, subject only to the satisfactory performance of the Service Provider's obligations under this Agreement Such payment shall be the Service Provider's sole right and remedy for such termination 5 Contract Sum The City shall pay the Service provider for the performance of this Contract, subject to additions and deletions provided herein, per the attached Exhibit "A", consisting of pages, and incorporated herein by this reference 6 City Representative The City will designate, prior to commencement of the work, its representative who shall make, within the scope of his or her authority, all necessary and proper decisions with reference to the services provided under this agreement All requests concerning this agreement shall be directed to the City Representative 7 Independent Service provider The services -to be performed by Service Provider are those of an independent service provider and not of an employee of the City of Fort Collins The City shall not be responsible for withholding any portion of Service Provider's compensation hereunder for the payment of FICA, Workmen's Compensation or other taxes or benefits or for any other purpose 8 Personal Services It is understood that the City enters into the Agreement based on the special abilities of the Service Provider and that this Agreement shall be considered as an agreement for personal services Accordingly, the Service Provider shall neither assign any responsibilities nor delegate any duties arising under the Agreement without the prior written consent of the City 9 Acceptance Not Waiver The City's approval or acceptance of, or payment for any of the services shall not be construed to operate as a waiver of any rights or benefits provided to the City under this Agreement or cause of action arising out of performance of this Agreement 3 SA rev06/07 10 Warranty (a) Service Provider warrants that all work performed hereunder shall be performed with the highest degree of competence and care in accordance with accepted standards for work of a similar nature (b) Unless otherwise provided in the Agreement, all materials and equipment incorporated into any work shall be new and, where not specified, of the most suitable grade of their respective kinds for their intended use, and all workmanship shall be acceptable to City (c) Service Provider warrants all equipment, materials, labor and other work, provided under this Agreement, except City -furnished materials, equipment and labor, against defects and nonconformances in design, materials and workmanship/workwomanship for a period beginning with the start of the work and ending twelve (12) months from and after final acceptance under the Agreement, regardless whether the same were furnished or performed by Service Provider or by any of its subcontractors of any tier Upon receipt of written notice from City of any such defect or nonconformances, the affected item or part thereof shall be redesigned, repaired or replaced by Service Provider in a manner and at a time acceptable to City 11 Default Each and every term and condition --hereof shall be deemed to be a material element of this Agreement In the event either party should fail or refuse to perform according to the terms of this agreement, such party may be declared in default thereof 12 Remedies In the event a party has been declared in default, such defaulting party shall be allowed a period of ten (10) days within which to cure said default In the event the default remains uncorrected, the party declaring default may elect to (a) terminate the Agreement and seek damages, (b) treat the Agreement as continuing and require specific performance, or (c) avail himself of any other remedy at law or equity If the non -defaulting party commences legal or equitable actions against the defaulting party, the defaulting party shall be liable to the non -defaulting party for the non -defaulting party's reasonable attorney fees and costs incurred because of the default 13 Binding Effect This writing, together with the exhibits hereto, constitutes the entire agreement between the parties and shall be binding upon said parties, their officers, 4 SA rev06/07