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HomeMy WebLinkAboutResolution - 2017-R0097 - UMC Physicians Network Services (PNS) - 03/09/2017Resolution No.2017-R0097 Item No.6.10 March 9,2017 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, an Agreement by and between UMC Physicians Network Services ("PNS")and the City of Lubbock,for medical clinic services, and related documents. Said Agreement is attached hereto and incorporated in this resolution as if fully set forth herein and shall be included in the minutes of the City Council. Passed by the City Council on March 9 7.017- DANIEL M.POPE,MAYOR ATTEST: APPROVED AS TO CONTENT: Leisa Hutcheson,Director of Human Resources And Risk Management APPR ,Tirst Assistant City Attorney RES.Contract-Medical Clinic Services 2.13.17 Resolution No. 2017-R0097 AGREEMENT FOR SERVICES for City of Lubbock Employee Medical Clinic Services This Agreement is between UMC Physicians, formerly known as UMC Physician Network Services ("UMCP") 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. UMCP is a Texas nonprofit corporation that operates and manages medical clinics and physician practices. UMCP desires to provide medical services to Plan Members. Therefore, the parties agree: ARTICLE 1: TERM AND TERMINATION 1.1 Prior Agreement. The Parties entered into an Agreement for Employee Medical Clinic Services effective February 1, 2014 ("Prior Agreement"). The Parties wish to restate the Agreement in its entirety. Therefore, upon execution of this Agreement, the Prior Agreement shall terminate, and the Parties shall continue their relationship under the terms of this Agreement. All rights or obligations of either Party accruing prior to the date of the Prior Agreement's termination shall be governed by the Prior Agreement. 1.2 Term. The term of this Agreement begins on its execution and continues through January 31, 2019. 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. UMCP shall provide access to Plan Members age two years and above except as otherwise indicated at the medical clinic locations described in Exhibit A, which Exhibit is attached to an incorporated into this Agreement. The medical clinic locations vary in staffing and services as described in Exhibit A. The City Manager is authorized to agree to changes in Exhibit A regarding medical clinic locations and services without need for further review or action by the City Council. 2.2 Services. UMCP shall use its best efforts to provide safe, high -quality, efficient healthcare to Plan Members. UMCP shall provide the following services: Agreement for Services: City of Lubbock Medical Clinic Services Page 1 of 10 Wisch\City of LBB\employee medical clinics\2017 a. Primary and Acute Medical Services. Plan Members may obtain medical care for primary and acute health care issues at any of clinics listed in Exhibit A. Primary and acute medical services include the services listed in Exhibit A. b. Immunizations. Plan Members may obtain immunizations at all participating clinic locations. C. Reporting. UMCP will provide to the City, no later than the 15`' 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 and (b) a savings report in a form to be agreed upon by UMCP and the City. 2.3 Medical Staffing. Some clinics may be staffed with nurse practitioners and physician assistants under the supervision of a physician. A supervising physician will always be available by phone for consultation with the provider. Other clinics may be staffed with physicians, nurse practitioners, physician assistants, laboratory technicians, radiology technicians, and other ancillary personnel. Each clinic location has the sole discretion to assign the level and type of provider for Plan Member services. All personnel will be appropriately qualified, licensed and credentialed to provide medical services in the State of Texas. 2.4 Operational Issues. UMCP 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: UMCP: Glen E. Frick Executive Director 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 1625 131" Street Lubbock, TX 79408 (806)775-2277 lutcheson@mylubbock.us With copy to: City Attorney City of Lubbock 1625 131h Street Lubbock, Texas 79401 A party will notify the other party promptly of any change to the contact information. 2.5 City Health Plan. UMCP 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 Agreement for Services: City of Lubbock Medical Clinic Services Page 2 of 10 Wisch\City of LBB\employee medical clinics\2017 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 UMCP. UMCP shall protect the confidentiality of patient information in compliance with all state and federal laws. UMCP shall not disclose patient information to the City without the Plan Member's written authorization unless disclosure is permitted by law. If UMCP ceases operation of a medical clinic, UMCP will transfer medical records and patient information to a successor medical provider in accordance with applicable laws. 2.8 Insurance. UMCP 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 UMCP self -insures as defined under the Texas Insurance Code, UMCP 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. UMCP shall maintain general liability insurance with a combined single limit of a minimum of $1,000,000 each occurrence and in the aggregate. UMCP shall maintain workers compensation insurance for its employees and shall provide a waiver of subrogation in favor of the City. 2.9 Indemnity. UMCP SHALL PROTECT, DEFEND, INDEMNIFY, AND HOLD HARMLESS, TO THE FULLEST EXTENT PERMITTED BY LAW, THE CITY AND CITY'S OFFICERS, EMPLOYEES, ELECTED 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 UMCP CONTEMPLATED HEREUNDER, OR THE OMISSION OF THE ACTIVITIES OF UMCP CONTEMPLATED HEREUNDER. UMCP 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. UMCP 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. 2.10 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 Agreement for Services: City of Lubbock Medical Clinic Services Page 3 of 10 Wisch\City of LBB\employee medical clinics\2017 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, the former shall control. ARTICLE 3: COMPENSATION 3.1 Fees. The City will pay UMCP the following amounts, payable within 30 days of the City's receipt of a monthly invoice from UMCP: a. Primary/Acute Medical Services -- $42,750.00 each month for up to 475 Plan Member visits per month PLUS $75.00 for each Plan Member visit over 475 per month. Member Visits for the purpose of counting against the base 475 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 billed to the City's existing health insurance plan or billed by the outside provider. • If a Plan Member is referred to West Wind or I-27 Medical Center for radiology services from another participating clinic, the Plan Member will be considered to have two visits. • Workers Compensation is not part of this agreement. b. Immunizations (available at all participating clinic locations) - • Will be charged separately at standard rates o HEP B -- $75 per injection (requires 3 injections) o Zostavax (shingles vaccine) -- $275 per injecton (requires an appointment) o HPV- $215 per injection (requires an appointment) o Flu Vaccine -- $25 per injection o Pneumonia Vaccine -- $40 per injection • Administration included If UMCP provides services to Plan Members and the services are not covered by this Agreement, UMCP 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 Agreement for Services: City of Lubbock Medical Clinic Services Page 4 of 10 Wisch\City of LBB\employee medical clinics\2017 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 any time funds are not appropriated for the continuance of this Agreement, cancellation shall be accepted by UMCP 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. UMCP 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. 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. Agreement for Services: City of Lubbock Medical Clinic Services Page 5 of 10 Wisch\City of LBB\employee medical clinics\2017 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. Signatures are on the following page. Date: March 9, 2017 CITY OF LUBBOCK By: Daniel M. Pope, Mayor ATTEST: o,j�'�-c- "/k - Reb cca Garza, City Secreta. APP V D S TO CONTENT: Leisa Hutcheson, Director of Human Resources & Risk Management Date: UMC PHYSICIANS A Glen E. Frick, Executive Director Agreement for Services: City of Lubbock Medical Clinic Services Page 6 of 10 Wisch\City of LBB\employee medical clinics\2017 EXHIBIT A CLINIC LOCATIONS AND SERVICES Hours of operation are subject to change. Holiday hours may vary. Types of Medical Clinics: ➢ Express Care at United Supermarkets ➢ Urgent Care ➢ Primary and Acute Care ➢ Specialized Care: Diabetes Care, Pediatrics UNITED EXPRESS CARE CLINICS Services are provided on a walk-in basis. Clinic Locations United Express Care 806-761-0428 2703 82°d Street Inside United Supermarket M-F 9:00 am-7:00pm; Sat 9:00am-6:00pm; Sun 1:00pm-6:00pm United Express Care 806-761-0429 1701 50th Street Inside United Supermarket M-F 9:00 am-7:00pm; Sat 9:00am-6:00pm; Sun 1:00pm-6:00pm United Express Care 806-762-0422 112 N. University Avenue Inside United Supermarket M-F 9:00 am-7:00pm; Sat 9:00am-6:00pm; Sun 1:00pm-6:00pm United Express Care 806-761-0424 12815 Indiana Avenue Inside United Supermarket M-F 9:00 am-7:00pm; Sat 9:00am-6:00pm; Sun 1:00pm-6:00pm Medical Services • 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 Laboratory Services AVAILABLE AT THIS LOCATION BUT NOT COVERED BY THIS AGREEMENT • Urine pregnancy tests • Glucose Test (finger stick) • Urine Analysis Radiology Not available Agreement for Services: City of Lubbock Medical Clinic Services Page 7 of 10 Wisch\City of LBB\employee medical clinics\2017 Immunizations • Charged separately at standard rates • Administration included URGENT CARE SERVICES Services are provided on a walk-in basis. The clinics are intended for urgent care issues and should not be used for ordinary and routine office visits. Clinic Locations Urgent Care Center at UMC 806-761-0545 808 Joliet Ave, Suite 130 Inside Medical Office Plaza II M-F 8a-9p, Sat -Sun 9a-6p Services • Minor injuries • Acute conditions — sore throats, ear, headache, fever, body aches • Allergies, cough, sinus • Asthma • Rashes • Stomach aches • Strains, sprains, musculoskeletal problems Laboratory Services AVAILABLE AT THIS LOCATION BUT NOT COVERED BY THIS AGREEMENT • Complete blood count • Urine analysis • Flu screen • Urine pregnancy tests • Strep screen Radiology AVAILABLE AT THIS LOCATION BUT NOT COVERED BY THIS AGREEMENT Immunizations • Charged separately at standard rates • Administration included PRIMARY CARE AND ACUTE CARE Services are provided on a walk-in or appointment basis. Clinic Locations Express Care Clinic at South Plains Mall 806-761-0450 6002 Slide Road, #P12 North side of mall, between Premiere Cinemas and Women's Dillard's, with interior and exterior entrances M-Sat 9a-8p, Sun 12p-6p (No Radiology; limited lab services) I-27 Medical Center 806-762-2633 4105 I-27 M-F 8a-8p, Sat 9a-5p, Sun 1 p-5p Agreement for Services: City of Lubbock Medical Clinic Services Page 8 of 10 Wisch\City of LBB\employee medical clinics\2017 Milwaukee Family Medicine 806-761-0464 7301 Milwaukee Avenue M-F 8a-8p, Sat 9a-5p, Sun 1p-5p West Wind Family Medicine 806-761-0475 5520 4th Street M-F 8a-8p, Sat 9a-5p, Sun 1p-5p Services • Chronic illness evaluation • Diabetes treatment and management • High cholesterol • Asthma • Acute conditions — sore throats, ear, headache, fever, body aches • Allergies, cough, sinus • Hypertension • Migraine • Rashes • Smoking Cessation • Stomach aches • Strains, sprains, musculoskeletal problems • Ordinary and routine office visits Laboratory Services AVAILABLE AT THIS LOCATION BUT NOT COVERED BY THIS AGREEMENT • Glucose • Glucometer test • Urine Analysis • Flu Screen • General Health Panel (CBC, TSH, CMP) • Comprehensive Metabolic Profile • Lipids • Thyroid • Complete Blood Count • PSA for males over 50 • Urine pregnancy tests Limited lab services at Express Care at South Plains Mall. Radiology AVAILABLE AT THIS LOCATION BUT NOT COVERED BY THIS AGREEMENT • Broken Bones, strains, skeletal x-rays — 1-2 views • Chest x-ray — 1-2 views Not available at Express Care at South Plains Mall. Immunizations • Charged separately at standard rates • Administration included Agreement for Services: City of Lubbock Medical Clinic Services Page 9 of 10 Wisch\City of LBB\employee medical clinics\2017 SPECIALTY SERVICES Services are provided on an appointment basis. Clinic Locations DIABETES CARE: UMC Diabetes Center 806-761-0540 808 Joliet Ave, Suite 120 Inside Medical Office Plaza II M-F 8a-5pm PEDIATRICS: accepts patients under age 2 UMC Northwest Pediatrics 806-761-0536 808 Joliet Avenue (at UMC) Medical Office Plaza II, Suite 110 Lubbock, Texas 79415 Will be moving to 416 Frankford Avenue in mid-2017 Services • For Diabetes Care: o Chronic illness evaluation o Diabetes treatment and management • For Pediatric Care: o General pediatric care o Minor injuries o Acute conditions — sore throats, ear, headache, fever, body aches o Allergies, cough, sinus o Asthma o Rashes o Stomach aches o Strains, sprains, musculoskeletal problems Laboratory Services AVAILABLE AT THIS LOCATION BUT NOT COVERED BY THIS AGREEMENT • Complete blood count • Urine analysis • Flu screen • Urine pregnancy tests • Strep screen Radiology AVAILABLE AT THIS LOCATION BUT NOT COVERED BY THIS AGREEMENT Immunizations • Charged separately at standard rates • Administration included Agreement for Services: City of Lubbock Medical Clinic Services Page 10 of 10 Wisch\City of LBB\employee medical clinics\2017 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 1 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 2016-149264 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. UMC Physicians Lubbock, TX United States Date Filed: 12/28/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Date Acknowledged: 12/30/2016 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 13-11530 Medical services for employees 4 Name of Interested Party City, State, Country (place of business Nature of interest (check applicable) Controlling I Intermediary Jimenez, Reyes Lubbock, TX United States X Maddux, Steven Lubbock, TX United States X Frick, Glen Lubbock, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said this the day of 20 , to certify which, witness my hand and seal of office. Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath r-ul[HZ- P1UVI U Uy 1CAdS r-uncs k,umrmssion www.etnics.state.tx.us Version V1.0.277 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 0f 1 Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-149264 UMC Physicians Lubbock, TX United States Date Filed: 12/28/2016 2 Name of governmental entity or state agency that is a party to the contract for which the form is being filed. City of Lubbock Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 13-11530 Medical services for employees 4 Name of Interested Party City, State, Country (place of business) Nature of interest (check applicable) Controlling I Intermediary Jimenez, Reyes Lubbock, TX United States X Maddux, Steven Lubbock, TX United States X Frick, Glen Lubbock, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. ,% Jk*f PIA HOLLEE MARIE HAMILTOI� ?_g'� `M Notary Public, State of Texas My Commission Expires August 03, 2017 Signature of authorized agent of contracting business entity AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said �I1W Ck, this the r day of—J)v iVl�eY 20to certify which, witness my hand and seal of office. I itilc,,ri� M�1-lah Rol &I v c(gPenfu o icer Wministering oath Printed name of officer administering oath Title of officer adm,_jhistering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277