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HomeMy WebLinkAboutRFP - 7438 MEDICAL PROVIDER - WORKERS COMPENSATION & DOT MEDICAL EXAMSRFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 1 of 16 REQUEST FOR PROPOSAL 7438 MEDICAL PROVIDER - WORKERS COMPENSATION & DOT MEDICAL EXAMS The City of Fort Collins is requesting 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. Proposals may be submitted by E-mail in Microsoft Word or PDF format. E-mail submittals shall be e-mailed to: purchasing@fcgov.com. If submitting hard copy proposals, five (5) copies, 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 26, 2012 and referenced as Proposal No. 7438. 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. The City encourages all disadvantaged business enterprises to submit proposals in response to all requests for proposals and will not be discriminated against on the grounds of race, color, national origin for all proposals for negotiated agreements. Questions concerning the scope of the project should be directed to Project Manager, Lance Murray at (970) 221-6807 or lmurray@fcgov.com. Questions regarding bid submittal or process should be directed to Jim O'Neill, CPPO, FNIGP, Buyer, at (970) 221-6779 or joneill@fcgov.com. A copy of the Proposal may be obtained as follows: 1. Download the Proposal/Bid from the BuySpeed Webpage, www.fcgov.com/eprocurement The City of Fort Collins is subject to public information laws, which permit access to most records and documents. Proprietary information in your response must be clearly identified and will be protected to the extent legally permissible. Proposals may not be marked ‘Proprietary’ in their entirety. Information considered proprietary is limited to material treated as confidential in the normal conduct of business, trade secrets, discount information, and individual product or service pricing. Summary price information may not be designated as proprietary as such information may be carried forward into other public documents. All provisions of any contract resulting from this request for proposal will be public information. Financial Services Purchasing Division 215 N. Mason St. 2nd Floor PO Box 580 Fort Collins, CO 80522 970.221.6775 970.221.6707 fcgov.com/purchasing RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 2 of 16 Sales Prohibited/Conflict 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 irregularities or informalities. Sincerely, James B. O'Neill II, CPPO, FNIGP Director of Purchasing & Risk Management RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 3 of 16 REQUEST FOR PROPOSAL 7438 MEDICAL PROVIDER- WORKERS COMPENSATION & DOT MEDICAL EXAMS 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 took effect requiring employers to provide employees two options of medical providers when an employee is injured on the job. The services are currently being provided by Poudre Valley Health Systems Occupational Health Services and Concentra. 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 with annual performance reviews. Fees will be reviewed and negotiated on an annual basis ninety (90) days prior to each annual expiration date. PROPOSAL GUIDELINES: 1. Qualified firms 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. Indicate 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. RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 4 of 16 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 time 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. Notification includes a phone call after initial treatment detailing treatment rendered, any work modifications or time lost, treatment plan forward as well as prompt access to the M164 or equivalent documentation detailing, injury/exposure, work restrictions, work relatedness and anticipated MMI timeline. This information should be transmitted to the city's electronic mail system. 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 (M164) outlining work restrictions, if any, for every visit. 6. Provide a written report within TWO (2) days of initial treatment to claim administrator. 7. Provide DOT medical exam results within 24 hours of service to the employer (Risk Management) and Department of Revenue. 8. Provide Risk Management and city employees with access to or copies of all written communications regarding medical treatment and DOT medical exams. 9. 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. RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 5 of 16 10. Be familiar with Workers' Compensation laws and provide hearing testimony when needed. 11. City employees shall initially be treated only by Level II accredited physicians for treatment of injury. Impairment ratings may only be completed by Level II accredited physicians. DOT medical exams must be completed by a medical examiner licensed, certified and/or registered in accordance with applicable State and or Federal laws and regulations. 12. Cooperate with the City's claim administrator and risk management staff in submitting information at their request as needed in a timely manner. 13. Participate in consultations with employer and claim administrator as requested to discuss specific cases and procedures. 14. Provide a written medical treatment plan when requested. 15. Conduct return to work or 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-à-vis the employees’ job duties. 16. Assess work relatedness upon initial employee visit to diminish the possibility of fraudulent claims. 17. Rely upon the most up to date Medical Treatment Guidelines adopted by the Colorado Division of Workers’ Compensation when treating patients and when determining work relatedness. Communicate a diagnosis-based treatment plan that includes specific treatment goals with expected time frames for completion in all cases where treatment falling within the purview of the medical treatment guidelines continues beyond 6 weeks. Within 14 days of request by any party, the provider shall supply a copy of the treatment plan both to the patient and to the payer. Should the patient otherwise require care that deviates from the medical treatment guidelines, the provider shall supply the patient and the employer with a written explanation of the medical necessity for such care. 18. Employees may be given a “Patient Satisfaction Survey” upon completion of medical services or when they reach MMI. RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 6 of 16 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 optional interview session. At discretion of the City, interviews of top rated firms may be held. 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 FACTOR QUALIFICATION STANDARD 2.0 Scope of Proposal Does the proposal show an understanding of the project objective, methodology to be used and results that are desired from the project? 2.0 Assigned Personnel Do the persons who will be working on the project have the necessary skills? Are sufficient people of the requisite skills assigned to the project? 1.0 Availability Can the work be completed in the necessary time? Can the target start and completion dates be met? Are other qualified personnel available to assist in meeting the project schedule if required? Is the project team available to attend meetings as required by the Scope of Work? 1.0 Motivation Is the firm interested and are they capable of doing the work in the required time frame? 2.0 Cost and Work Hours Do the proposed cost and work hours compare favorably with the project Manager's estimate? Are the work hours presented reasonable for the effort required in each project task or phase? 2.0 Firm Capability Does the firm have the support capabilities the assigned personnel require? Has the firm done previous projects of this type and scope? RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 7 of 16 REFERENCE EVALUATION (TOP RATED FIRM) The project Manager will check references using the following criteria. The evaluation rankings will be labeled Satisfactory/Unsatisfactory. QUALIFICATION STANDARD Overall Performance Would you hire this Professional again? Did they show the skills required by this project? Timetable Was the original Scope of Work completed within the specified time? Were interim deadlines met in a timely manner? Completeness Was the Professional responsive to client needs; did the Professional anticipate problems? Were problems solved quickly and effectively? Budget Was the original Scope of Work completed within the project budget? Job Knowledge a) If a study, did it meet the Scope of Work? b) If Professional administered a construction contract, was the project functional upon completion and did it operate properly? Were problems corrected quickly and effectively? RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 8 of 16 SAMPLE 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 ( ) page and incorporated herein by this reference. 2. The Work Schedule. [Optional] The services to be performed pursuant to this Agreement shall be performed in accordance with the Work Schedule attached hereto as Exhibit "B", consisting of ( ) page , and incorporated herein by this reference. 3. Time of Commencement and Completion of Services. The services to be performed pursuant to this Agreement shall be initiated within ( ) days following execution of this Agreement. Services shall be completed no later than . Time is of the essence. Any extensions of the time limit set forth above must be agreed upon in a writing signed by the parties. 4. Contract Period. [Option 1] This Agreement shall commence upon the date of execution shown on the signature page of this Agreement and shall continue in full force and effect for one (1) year, unless sooner terminated as herein provided. In addition, at the option of the City, the Agreement may be extended for an additional period of one (1) year at the rates provided with written notice to the Professional mailed no later than ninety (90) days prior to contract end. 5. Contract Period. [Option 2] This Agreement shall commence , 200 , RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 9 of 16 and shall continue in full force and effect until , 200 , unless sooner terminated as herein provided. In addition, at the option of the City, the Agreement may be extended for additional one year periods not to exceed ( ) additional one year periods. Renewals and pricing changes shall be negotiated by and agreed to by both parties. The Denver Boulder Greeley CPIU published by the Colorado State Planning and Budget Office will be used as a guide. Written notice of renewal shall be provided to the Service Provider and mailed no later than ninety (90) days prior to contract end. 6. Delay. 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. [Early Termination clause here as an option 7. Early 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 Fort Collins, CO 80522 Copy to: City of Fort Collins Attn: PO Box 580 Fort Collins, CO 80522 Service Provider: 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. RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 10 of 16 8. 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 " ", consisting of page , and incorporated herein by this reference. 9. 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. 10. 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. 11. 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. 12. 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. 13. 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. RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 11 of 16 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. 14. 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. 15. 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. 16. 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, employees, agents and assigns and shall inure to the benefit of the respective survivors, heirs, RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 12 of 16 personal representatives, successors and assigns of said parties. 17. 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 , 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. 18. 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. 19. 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. 20. Prohibition Against Employing Illegal Aliens. Pursuant to Section 8-17.5-101, C.R.S., et. seq., Service Provider represents and agrees that: RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 13 of 16 a. As of the date of this Agreement: 1. Service Provider does not knowingly employ or contract with an illegal alien who will perform work under this Agreement; and 2. Service Provider will participate in either the e-Verify 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 “e-Verify Program”) or the Department Program (the “Department Program”), an employment verification program established pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment eligibility of all newly hired employees to perform work under this Agreement. b. Service Provider 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. Service Provider is prohibited from using the e-Verify Program or Department Program procedures to undertake pre-employment screening of job applicants while this Agreement is being performed. d. If Service Provider obtains actual knowledge that a subcontractor performing work under this Agreement knowingly employs or contracts with an illegal alien, Service Provider shall: 1. Notify such subcontractor and the City within three days that Service Provider 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 Service Provider shall not terminate RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 14 of 16 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. e. Service Provider 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. f. If Service Provider 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, Service Provider shall be liable for actual and consequential damages to the City arising out of Service Provider’s violation of Subsection 8-17.5-102, C.R.S. g. The City will notify the Office of the Secretary of State if Service Provider violates this provision of this Agreement and the City terminates the Agreement for such breach. 21. 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. RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 15 of 16 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 Seal) _____________________________ CORPORATE SECRETARY RFP 7438 Medical Provider – Workers Compensation & DOT Medical Exams Page 16 of 16 EXHIBIT “ ” 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.