HomeMy WebLinkAboutResolution - 2010-R0604 - RFP 10-133-DT Medical Services Clinics For City Employees - 12/15/2010Resolution No. 2010-RO604
December 15, 2010
Item No. 5.4
RESOLUTION
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK:
THAT the Mayor of the City of Lubbock is hereby authorized and directed to
execute for and on behalf of the City of Lubbock, a Contract with UMC Physicians
Network Services for medical services clinic for employees and eligible dependents, a
copy of which Contract is attached hereto and incorporated herein as part of this
Resolution; and
THAT the Mayor or his designee may execute any routine documents and forms
associated with said Contract.
Passed by the City Council on _ December 15, 2010
TOM MARTIN, MAYOR
ATTEST:
ca Garza, City Secre
RebAs.
APPROVED AS TO CONTENT:
Ij A
Leisa Hutcheson, Director of Human Resources
APPROVED AS TO FORM:
ith W; rZ �'
vw:ccdocs:'RES. Contract -UMC Physicians Network Services
November 23, 2010
AGREEMENT FOR SERVICES Resolution No. 2010-RO604
for
City of Lubbock Employee Medical Clinic Services Conti -act: 9SG
This Agreement is between UMC Physician Network Services ("PNS") and the City of Lubbock ("the
City").
City is a Texas municipality. It maintains the City of Lubbock Health Care Plan for its employees and their
eligible dependents (hereinafter called "Plan Members"). City desires to establish medical clinic
locations within the city limits of Lubbock, Texas for City's Plan Members. The availability of one or
more medical clinics would provide convenience and greater access to quality health care for Plan
Members at an efficient and affordable cost to the City.
PNS is a Texas nonprofit corporation that operates and manages medical clinics and physician practices.
PNS desires to provide medical services to Plan Members.
Therefore, the parties agree:
ARTICLE 1: TERM AND TERMINATION
1.1 Term. The term of this Agreement begins on February 1, 2011 and continues for a three-year
term through January 31, 2014.
1.2 Renewal. This Agreement shall renew only upon further written agreement of the parties.
1.3 Termination. Either party may terminate this Agreement at any time without cause by giving
the other party ninety (90) days written notice of termination. Either party may terminate the
agreement for cause provided the other party fails to cure a default within fifteen days prior written
notice of the default.
ARTICLE 2: RESPONSIBILITIES
2.1 Medical Clinics. PNS shall provide access to Plan Members age two years and above at three
medical clinic locations as described below.
2.1.1. West Wind Primary Health Center. West Wind is located at 4th Street and Elkhart
Avenue, Lubbock, Texas (Northwest location). West Wind Primary Health Center will provide
primary and acute health care services. All of the services will be directed by the health care
provider as needed to provide the high quality health care. If the Plan Member needs care
outside the scope of the services offered at West Wind, PNS will assist in obtaining an
appointment for the Plan Member with an appropriate health care provider within the Plan
Member's Health Plan Network. West Wind will be open seven days a week with extended
hours. West Wind will be open Monday through Friday 8:00 AM until 8:00 PM, Saturday 9:00
AM until 5:00 PM, and Sunday 1:00 PM until 5:00 PM. If these hours change substantially, PNS
will notify the City. Plan Members may obtain services on a walk-in or appointment basis.
2.1.2 Living Well Express Care (Boston) and Living Well Express Care (Avenue Q). The
Boston Living Well Express Care clinic is located in the United Supermarket at 82nd and Boston
Agreement for Services: City of Lubbock Medical Clinic Services Page 1 of 8
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Avenue, Lubbock, Texas (South location). The Avenue Q Living Well Express Care clinic is located
in the Untied Supermarket at 50th Street and Avenue Q. The clinics will provide acute care
services. The Health Care Provider will determine if the Plan Member needs to be treated at a
different location. If the Plan Member needs care outside the scope of the services offered at
the clinic, PNS will assist in obtaining an appointment for the Plan Member with an appropriate
health care provider within the Plan Member's Health Plan Network. The clinics will be open
Monday through Friday 9:00 am until 7:00 PM, Saturday 9:00 AM until 6:00 PM, and Sunday
1:00 PM until 6:00 PM. If these hours change substantially, PNS will notify the City. Plan
Members may obtain services on a walk-in basis.
2.1.3 HealthPoint. HealthPoint is located at 4004 82nd Street Lubbock, TX. This clinic will
provide primary and acute medical services. The Health Care Provider will determine if the Plan
Member needs to be treated at a different location. If the Plan Member needs care outside the
scope of the services offered at the clinic, PNS will assist in obtaining an appointment for the
Plan Member with an appropriate health care provider within the Plan Member's Health Plan
Network. The clinic will be open Monday through Friday from 8:00 am to 5:00pm. If these
hours change substantially, PNS will notify the City. Plan Members may obtain services on an
appointment basis only.
2.2 Services. PNS shall use its best efforts to provide safe, high-quality, efficient healthcare to Plan
Members.
2.2.1 Primary and Acute Medical Services. Plan Members may obtain medical care for
primary and acute health care issues at any of the four clinics. Primary and acute medical
services include the services listed in Exhibit A.
2.2.2 Health Risk Assessment. PNS OccMed Department will go onsite to the City's locations
to perform Health Screenings for the Plan Members to include one of the two options: (1) Blood
draw (CBC, CMP, PSA (males over 50), Lipid Profile), Body Mass Index, Body Fat Percentage,
weight, height, blood pressure, and pulse. PNS would then mail the Plan Member their results
with explanations and meanings of each result. (2) Finger stick (Lipid Profile and Glucose), Body
Mass Index, Body Fat Percentage, weight, height, blood pressure, pulse, rapid results with
onsite review and explanation of the results. The Plan Member would leave the screening with
their screening results. Prior to the screening, the Plan Members will complete either an Online
Health Risk Assessment Questionnaire or a Paper Health Risk Assessment Questionnaire and
return it to the PNS OccMed Department. PNS will perform pre -scheduled Health Screenings by
groups in coordination with the City's preferences through the PNS OccMed Department.
2.2.3 Reporting. PNS will provide to the City, no later than the 15th day of the month
immediately following the end of each month of the calendar year, a written report with respect to the
provision of the medical services during the immediately preceding month. The written report shall be
in a form reasonably satisfactory to the City and shall specifically indicate (a) the number of covered Plan
Members seen with diagnosis codes, (b) the number of Health Risk Assessments conducted, and (c)
savings report in a form to be agreed upon by PNS and the City.
2.3 Medical Staffing. The Living Well Express Care clinics will be staffed with nurse practitioners
and physician assistants under the supervision of a physician. The West Wind and HealthPoint clinics
will be staffed with physicians, nurse practitioners, physician assistants, laboratory technicians,
radiology technicians, and other ancillary personnel. All personnel will be appropriately qualified,
licensed and credentialed to provide medical services in the State of Texas.
Agreement for Services: City of Lubbock Medical Clinic Services Page 2 of 8
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2.4 Operational Issues. PNS and the City designate the following contact persons for operational
issues and coordination of services, as well as for any notices required to be delivered hereunder:
PNS: Glen Frick
Chief Operating Officer
5219 City Bank Parkway, Suite 135
Lubbock, TX 79407
(806)761-0333
glen.frick@umchealthsystem.com
City: Leisa Hutcheson
Director of Human Resources & Risk Management
162513 th Street
Lubbock, TX 79408
(806)775-2277
Ihutcheson@mylubbock.us
With copy to:
City Attorney
City of Lubbock
162513 th Street
Lubbock, Texas 79401
A party will notify the other party promptly of any change to the contact information.
2.5 City Health Plan. PNS will cooperate with the City to work within the City's health benefit
structure and assure proper services and referrals within the provider network and available benefits.
This provision shall not restrict a healthcare provider from discussing all health care options with a
patient. The parties will cooperate to promote the use of the clinics to Plan Members.
2.6 Plan Member Identification. The City will provide its Plan Members with identification cards
that show the person's status as a Plan Member.
2.7 Patient Information. All medical records and patient information maintained by the medical
clinic shall be the property of PNS. PNS shall protect the confidentiality of patient information in
compliance with all state and federal laws. PNS shall not disclose patient information to the City
without the Plan Member's written authorization unless disclosure is permitted by law. If PNS ceases
operation of a medical clinic, PNS will transfer medical records and patient information to a successor
medical provider in accordance with applicable laws.
2.8 Insurance. PNS shall maintain professional liability insurance for itself and its medical providers
throughout the term of this Agreement, in the minimum annual coverage amounts and type acceptable
to the City. In the alternative, if PNS self -insures as defined under the Texas Insurance Code, PNS shall
provide to the City all state filings indicating solvency of any self-insured plan and any other proof of
solvency as may be required by the City. PNS shall maintain general liability insurance with a combined
single limit of a minimum of $1,000,000 each occurrence and in the aggregate. PNS shall maintain
workers compensation insurance for its employees and shall provide a waiver of subrogation in favor of
the City.
2.9 Indemnity. PNS SHALL PROTECT, DEFEND, INDEMNIFY, AND HOLD HARMLESS, TO THE
FULLEST EXTENT PERMITTED BY LAW, THE CITY AND CITY'S OFFICERS, EMPLOYEES, ELECTED
Agreement for Services: City of Lubbock Medical Clinic Services Page 3 of 8
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OFFICIALS, AND/OR AGENTS FROM AND AGAINST ANY AND ALL LOSSES, DAMAGES, CLAIMS OR
LIABILITIES, OF ANY KIND OR NATURE, WHICH ARISE DIRECTLY OR INDIRECTLY FROM. OR ARE
RELATED TO, IN ANY WAY, MANNER OR FORM, THE ACTIVITIES OF PNS CONTEMPLATED HEREUNDER,
OR THE OMISSION OF THE ACTIVITIES OF PNS CONTEMPLATED HEREUNDER. PNS FURTHER
COVENANTS AND AGREES TO DEFEND ANY SUITS OR ADMINISTRATIVE PROCEEDINGS BROUGHT
AGAINST THE CITY AND/OR THE CITY'S OFFICERS, EMPLOYEES, ELECTED OFFICIALS, AND/OR AGENTS
ON ACCOUNT OF ANY SUCH CLAIM, AND, WITHOUT LIMITING THE INDEMNITY PROVIDED HEREIN, TO
PAY OR DISCHARGE THE FULL AMOUNT OR OBLIGATION OF ANY SUCH CLAIM INCURRED BY,
ACCRUING TO, OR IMPOSED ON THE CITY, OR THE CITY'S OFFICERS, EMPLOYEES, ELECTED OFFICIALS,
AND/OR AGENTS, AS APPLICABLE, RESULTING FROM ANY SUCH SUITS, CLAIMS, AND/OR
ADMINISTRATIVE PROCEEDINGS OR ANY MATTERS RESULTING FROM THE SETTLEMENT OR
RESOLUTION OF SAID SUITS, CLAIMS, AND/OR ADMINISTRATIVE PROCEEDINGS. PNS DOES NOT
AGREE TO PROTECT, DEFEND, INDEMNIFY, AND HOLD HARMLESS THE CITY AND CITY'S OFFICER,
EMPLOYEES, ELECTED OFFICIALS, AND/OR AGENTS FROM AND AGAINST CLAIMS AND LIABILITIES
ARISING FROM THE CITY'S DUTIES, ACTS, OR OMISSIONS REGARDING ACTIVITIES UNDER THIS
AGREEMENT.
THE INDEMNITY AND RELEASE PROVIDED HEREIN SHALL SURVIVE THE TERMINATION OR
VOIDANCE OF THIS AGREEMENT.
ARTICLE 3: COMPENSATION
3.1 Fees. The City will pay PNS the following amounts, payable within 30 days of the City's receipt
of a monthly invoice from PNS:
Primary/Acute Medical Services -- $39,335 each month for up to 450 Plan Member visits per
month PLUS $72.50 for each Plan Member visit over 450 per month. Member Visits for the
purpose of counting against the base 450 visits shall include only those visits where the Member
is seen and treated by the health care professional. Member Visits shall not include paperwork
drop-offs by Members, telephone consultations, if any, setting of appointments by Members, or
other contacts wherein direct, in-person professional medical services are not rendered.
• Lab tests and radiology tests will be excluded from this agreement and billed separately
to the City's existing health insurance plan.
• The health care provider will administer allergy injections if the Plan Member provides
the allergy serum. The administration of the injection is included in the visit fee.
• Lab tests ordered from an outside location are not included in the visit fee and will be an
additional fee or billed by the outside provider.
• If a Plan Member is referred to West Wind or HealthPoint for radiology services from a
Living Well Express Care clinic, the Plan Member will be considered to have two visits.
Radiology tests performed at other locations and films referred for reading to a
radiologist are not covered. Examples of radiology services not provided at West Wind
or HealthPoint are MRI scans, CT scans, bone density scans, and mammograms.
• Workers Compensation is not part of this agreement.
Health Risk Assessment -- $105.00 per Health Risk Assessment (screening and questionnaire)
billed separately from medical services.
Immunizations (available at West Wind and HealthPoint only) --
• HEP B -- $75 per injection (requires 3 injections)
Agreement for Services: City of Lubbock Medical Clinic Services Page 4 of 8
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• Zostavax (shingles vaccine) -- $250 per injection
• HPV—$165 per injection
• Flu Vaccine -- $25 per injection
• Pneumonia Vaccine -- $40 per injection
If PNS provides services to Plan Members and the services are not covered by this Agreement,
PNS will bill the Health Plan, and the Plan Member will be responsible for applicable
copayments.
3.2 Nonappropriation. All funds for payment by the City under this Contract are subject to the
availability of an annual appropriation for this purpose by the City. In the event of non -appropriation of
funds by the City Council of the City of Lubbock, for the services provided under this Agreement, the City
may terminate the Agreement, without termination charge or other liability, on the last day of the then -
current fiscal year or when the appropriation made for the then -current year for the services is spent,
whichever event occurs first. If at anytime funds are not appropriated for the continuance of this
Agreement, cancellation shall be accepted by PNS on thirty (30) days prior written notice.
ARTICLE 4: RELATIONSHIP OF THE PARTIES
INDEPENDENT CONTRACTOR STATUS: Nothing in this agreement is intended nor shall be construed to
create an employer/employee relationship between the contracting parties. The sole interest and
responsibility of the parties is to ensure that the services covered by this agreement shall be performed
and rendered in a competent, efficient and satisfactory manner.
ARTICLE 5: GENERAL PROVISIONS
5.1 Non -Discrimination. Each party shall provide services without discrimination on the basis of
race, color, national origin, ethnicity, age, sex, disability, or political or religious beliefs. PNS shall not
discriminate in hiring, promotion, treatment, or other terms and conditions of employment based on
race, sex, national origin, ethnicity, age, disability, or political or religious beliefs, or in any way violative
of Title VII of 1964 Civil Rights Act and amendments, except as permitted by said laws.
5.2 Waiver. The waiver by either party of a breach or violation of any provision of this Agreement
shall not operate as or be construed to be a waiver of any subsequent breach of any provision of the
Agreement.
5.3 Severability. If any term or provision of this agreement is held to be invalid for any reason, the
invalidity of that section shall not affect the validity of any other section of this agreement provided that
any invalid provisions are not material to the overall purpose and operation of this agreement. The
remaining provisions of this agreement shall remain in full force and shall in no way be affected,
impaired, or invalidated.
5.4 Assignment. Neither party shall have the right to assign or transfer their rights to any third
parties under this agreement.
5.5 Governing Law And Venue. This agreement shall be governed by and construed and enforced
in accordance with the laws of the State of Texas and any applicable Federal Law or Statute. Venue shall
be in Lubbock, Lubbock County, Texas for all purposes.
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5.6 Amendment. This agreement may be amended in writing to include any provisions that are
agreed to by the contracting parties.
5.7 Exclusion. Each party certifies that neither it nor its employees or contractors is presently
debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from
participation in any government program by any federal department or agency or by the State of Texas.
EACH PARTY WILL NOTIFY PROMPTLY THE OTHER PARTY if this status changes and the name of any
person who provides services under this Agreement or is an agent or managing employee who is
convicted of a criminal offense related to the person's involvement in a government program or is
suspended, debarred, or excluded from participation in a government program.
5.8 Notice. All notices required or permitted to be given under this Agreement shall be sufficient if
furnished in writing, sent by certified mail, return receipt requested to the party's last known principal
office.
5.9 Authority. The undersigned to this Agreement hereby represent and warrant their respective
authority to execute this Agreement.
Date: December 15, 2010
CITY OF LUBBOCK
By:
Tom Martin, Mayor
ATTEST:
Rebe a Garza, City Secretary
APPROV D AS TO CONTENT:
l
Leisa Hutcheson, Director of Human Resources
& Risk Management
APPROVED AS TO FORM:
Mitchell Satterwhite, Assistant City Attorney
Date: 11-30—(o
UMC PHYSICIAN NETWORK SERVICES
By.
Glen Frick
Chief Operating Officer
Agreement for Services: City of Lubbock Medical Clinic Services Page 6 of 8
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EXHIBIT A
CLINIC LOCATIONS AND SERVICES
Resolution No. 2010—RO604
LIVING WELL EXPRESS CARE CLINICS
Services are provided on a walk-in basis.
Living Well Express Care 806-761-0428
270382 n1 St. (82nd & Boston)
Inside United Supermarket
M -F 9:00 am-7:00pm; Sat 9:00am-6:00pm; Sun 1:00pm-6:00pm
Living Well Express Care 806-761-0429
170150" St. (50th & Ave. Q)
Inside United Supermarket
M -F 9:00 am-7:00pm; Sat 9:00am-6:00pm; Sun 1:00pm-6:00pm
Services provided under this Agreement include but are not limited to:
Ordinary and routine healthcare
Diagnosis of diabetes and referral to PCP for treatment
Asthma
Acute conditions -sore throats, ears, headache, fever, body aches
Allergies/Cough/Sinus
Rashes
Stomach aches
Strains/sprains/musculoskeletal problems
Urine pregnancy tests
Glucose Test (finger stick)
No radiology
Immunizations/Injections:
• Will be charged separately at standard rates
• Administration included
• Based on availability
Agreement for Services: City of Lubbock Medical Clinic Services Page 7 of 8
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Primary Care Services
Services are provided on a walk-in or appointment basis.
Health Point 806-722-3131
400482 nd Street
Lubbock, TX 79423
M -F 8:00 am -5:00 pm (closed 12:00 pm -1:00 pm)
West Wind Primary Health Care 806-761-0475
55204 th Street
Lubbock, TX 79416
M -F 8a -8p, Sat 9a -5p, Sun 1p -5p
Services provided under this Agreement include but are not limited to:
Ordinary and routine healthcare
Asthma
Acute conditions- sore throat, ears, headache, fever, body aches
Allergies/Cough/Sinus
Rashes
Stomach aches
Strains/sprains/musculoskeletal problems
Urine pregnancy tests
Immunizations/Injections:
• Will be charged separately at standard rates
• Administration included
• Based on availability
Agreement for Services: City of Lubbock Medical Clinic Services Page 8 of 8
c:\wisch\pns\city — k v2.doc (2011)
AMENDMENT
Agreement for Services
City of Lubbock Employee Medical Clinic Services
This Amendment applies to an Agreement previously entered into between UMC Physician
Network Services ("PNS") and the City of Lubbock ("the City"), Contract Number 9864,
effective February 1, 2011.
The Agreement and this Amendment set forth all terms, conditions, and requirements for the
parties and supersede any earlier agreements, writings, or promises. In the event of conflict or
inconsistency between the Agreement and this Amendment, the terms of this Amendment shall
govern.
The parties agree to amend the Agreement as follows, effective upon execution of this
Amendment:
Add the following to Paragraph 2.1, "Medical Clinics ":
2.1.4 South Plains Mall Express Care Clinic. The Express Care clinic is located
inside the South Plains Mall (next to Premiere Cinemas) and will begin operations on or
about late January 2013. The clinic will provide acute care services. The Health Care
Provider will determine if the Plan Member needs to be treated at a different location. If
the Plan Member needs care outside the scope of the services offered at the clinic, PNS
will assist in obtaining an appointment for the Plan Member with an appropriate health
care provider within the Plan Member's Health Plan Network. The clinic will be open
Monday through Friday 9:00 AM until 8:00 PM, Saturday 9:00 AM until 7:00 PM and
Sunday 12:00 PM until 6:00 PM. If these hours change substantially, PNS will notify
the City. Plan Members may obtain services on a walk-in basis.
Amendment to Agreement for Services — Page 1 of 4
City of Lubbock Employee Medical Clinic Services
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EXHIBIT "A"
CLINIC LOCATIONS AND SERVICES
South Plains Mall Express Care
6002 Slide Road - Space #P 12
Lubbock, Texas 79414
Inside the SPMall next to Premiere Cinemas
M -F 9:00 am-8:00pm; Sat 9:00am-7:00pm; Sun 12:00pm-6:00pm
Services provided at this location:
Ordinary and routine healthcare
Diagnosis of diabetes and referral to PCP for treatment
Asthma
Acute conditions -sore throats, ears, headache, fever, body aches
Allergies/Cough/Sinus
Rashes
Stomach aches
Strains/sprains/musculoskeletal problems
Urine pregnancy tests
Glucose Test (finger stick)
No radiology
Immunizations Injections:
• Will be charged separately at standard rates
• Administration included
• Based on availability
All other terms and conditions of the Agreement shall continue in full force and effect without
change.
This contract amendment is subject to the City of Lubbock's Non -Arbitration clause listed in
"Exhibit B".
CITY OF LUBBOCK UMC PHYSICIAN NETWORK
SERVICE
B � By:
K A REN GIB SON. MAYOR PRO TEM Glen Frick, Chief Operating Officer
Date:
Amendment to Agreement for Services —
City of Lubbock Employee Medical Clinic Services
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Date: /- / � - 13
Page 2 of 4
ATTEST:
Rebe a Garza, City Secretary
APPROV D AS TO LATENT:
(Z:
Leisa Hutcheson, Director of Human Resources
& Risk Management
Amendment to Agreement for Services — Page 3 of 4
City of Lubbock Employee Medical Clinic Services
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EXHIBIT "B"
A. Non -Arbitration
The City reserves the right to exercise any right or remedy available to it by law,
contract, equity, or otherwise, including without limitation, the right to seek any
and all forms of relief in a court of competent jurisdiction. Further, the City shall
not be subject to any arbitration process prior to exercising its unrestricted right to
seek judicial remedy. The remedies set forth herein are cumulative and not
exclusive, and may be exercised concurrently. To the extent of any conflict
between this provision and another provision in, or related to, this document, this
provision shall control.
Amendment to Agreement for Services — Page 4 of 4
City of Lubbock Employee Medical Clinic Services
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