HomeMy WebLinkAbout12. Kaiser Health Services
AGENDA MEMO
DATE: June 22, 2010
TO:
Mayor and Members of the City Council
FROM
Office of the City Manager
By: Irma Youssefieh, Human Resources Director
SUBJECT: Approval for Southern California Permanente Medical Group to
Provide Occupational Health Services for the City of Downey
RECOMMENDATION
That the City Council authorize staff to approve an agreement with Southern California
Permanente Medical Group (SCPMG) (“Kaiser OHSS”) to provide occupational health
and safety services for the City of Downey.
DISCUSSION
Since 2005 Health First Medical Group located in Santa Fe Springs has provided
occupational health and safety services for employees of the City. These type of
services include pre-placement medical examinations to determine a new hire’s ability
to perform the essential functions of the position and return to work examinations to
verify and determine an employee’s ability to safely perform the essential functions of
the position after an extended medical leave of absence and/or if a business need is
determined by City management to evaluate an employee’s fitness for duty.
Over the past few months, staff has been in discussions with Kaiser on the City’s
occupational health protocols and costs for the services above including physical
examinations for sworn police and fire employees. In May 2009, the City Council
authorized staff to sign a Letter of Agreement for the Kaiser Medical Group to provide
executive management physicals while staff continued to work with Kaiser on rates for
the other occupational health services listed above.
Attached is the proposal provided by Kaiser for the remaining occupational health
services which comply with health and safety industry standards. Staff has reviewed
these costs and finds Kaiser’s rates to be competitively priced. In some areas, Kaiser
rates are higher due to itemized costing rather than a bundled rate as provided by
Health First Medical Group.
In addition to quality and reliable medical services and information, the close proximity
of Kaiser medical facilities and its location in the City of Downey is a valued benefit.
Also, Kaiser Occupational Health and Safety Services is currently an authorized medical
provider for the City’s workers’ compensation program.
CITY OF DOWNEY, CALIFORNIA
FISCAL IMPACT
A non-sworn pre-placement medical exam averages $200.25; a sworn (police and fire)
pre-placement medical exam averages approx. $1,002; a return to work/fitness for duty
evaluation is approximately $335;and the physicals for sworn police and fire are
approximately $772 formale/female under 45 and $1,075 for male/female over 45.
Attachment
June 17, 2010
Contact Name: Irma Youssefieh
CITY OF DOWNEY OHSS
Company:
Address: 11111 Brookshire Avenue
City of Downey, CA 90241
Re: Letter of Agreement for Occupational Health and Safety Services between The Southern
California Permanente Medical Group and CITY OF DOWNEY OHSS
Dear Irma,
Through a series of meetings, CITY OF DOWNEY OHSS and The Southern California Permanente
Medical Group (“SCPMG”) have reached an agreement regarding SCPMG’s provision of occupational
health and safety services to CITY OF DOWNEY OHSS. The purpose of this letter is to set forth this
agreement.
SCPMG, through its Occupational Health Centers collectively known as Kaiser On-the-Job, will provide
occupational health and safety services, as requested by CITY OF DOWNEY OHSS. This letter does not
obligate CITY OF DOWNEY OHSS to utilize SCPMG services, but it does set forth applicable prices and
conditions of such services when elected by CITY OF DOWNEY OHSS.
What SCPMG Will Do For CITY OF DOWNEY OHSS
SCPMG physicians and other practitioners will provide services for CITY OF DOWNEY OHSS’s current
or prospective workers as requested by CITY OF DOWNEY OHSS. The prices for such services are
listed in Schedule A, attached to this letter. SCPMG will complete appropriate documentation of those
services. If further tests or other services are required, SCPMG will notify CITY OF DOWNEY OHSS.
SCPMG shall submit a monthly invoice to CITY OF DOWNEY OHSS for services rendered during the
previous month.
CITY OF DOWNEY OHSS’s Obligations
If and when CITY OF DOWNEY OHSS determines to send prospective employees or employees to
SCPMG for services, CITY OF DOWNEY OHSS will specify the services to be performed by SCPMG.
CITY OF DOWNEY OHSS agrees to pay SCPMG for services rendered within thirty days after receipt of
the invoice.
General Provisions of This Letter of Agreement
June 23, 2010May 11, 2011
This letter of agreement will be in force for the period of through
12 month periods thereafter, unless either party provides written notification of termination at least 30
days before the end of each 12 month period. This letter of agreement can also be terminated by either
party; such termination shall be effective thirty days from the notice of the terminating party.
SCPMG reviews its prices for occupational health and safety services on a yearly basis. If SCPMG
determines to change its prices, it shall notify CITY OF DOWNEY OHSS of any price changes at least 45
days prior to the effective date of the change.
It is so agreed on , 2010
The Southern California Permanente Medical Group
Occupational Health
John Harbaugh, MD
Coordinator – SCAL:
Signature:
Date:
CITY OF DOWNEY OHSS
CITY OF DOWNEY
OHSSIrma Youssefieh
Representative:
Signature:
Date:
Title: Human Resources Director
Address: 11111 Brookshire Avenue Downey, CA 90241
Phone: 562-904-7294
Fax:
LOA Created By: Christina Lara
LOA Creation Date: 5-11-10 revised
Schedule A
OCCUPATIONAL HEALTH AND SAFETY SERVICES TO BE PROVIDED TO CITY OF DOWNEY
OHSS
Services will be provided to CITY OF DOWNEY OHSS as follows:
Item CPT Description of Services Cost of
CODEServices
Visit Category # 1 Clerical &
1.
Administration Positions
2. 207251 Pre-placement Physical Exam $ 65.00
(includes: medical history,
vitals, height, weight, hearing check (whisper test) visual
screen (color/far/near)
3. 86580 PPD, Step 1 $ 20.00
4. Lift up to 10 pounds routinely No test
5. 80100Rapid Quick Test (Non-DOT Drug Screen)Bill to TPA
(Preferred Alliance)
Optional:
6.
7. 71020 Chest X-ray, 2view (If positive PPD)$ 65.00
Visit Category # 2 Support Positions
8.
9. 207251 Pre-placement Physical Exam$ 65.00
(includes: medical history,
vitals, height, weight, hearing check (whisper test) visual
screen (color/far/near)
10. 86580 PPD, Step 1 $ 20.00
11. 80100Drug Screen Collection (Non-DOT) Bill to TPA
(Preferred Alliance)
12. Lift up to 25 pounds frequently; occasional lifting up to Included in
examination
50 pounds
Optional:
13.
14. 72100 Back X-Ray /3 view (based on medical $ 70.00
history/questionnaire)
15. 71020 Chest X-ray, 2 view (If positive PPD) $ 65.00
Visit Category # 3 Transit Driver, Maintenance
16.
Worker, Water Service Operator, & Graffiti
Abatement Positions
17. 207251 Pre-placement Physical Exam $ 65.00
(includes: medical history,
vitals, height, weight, hearing check (whisper test) visual
screen (color/far/near)
18. 86580 PPD, Step 1 $ 20.00
19. Frequently lift 50 pounds or more. I
ncluded in
examination
20. 80100Rapid Quick Test (Non-DOT Drug Screen) Bill b TPA
(Preferred Alliance)
Optional:
21.
22. 72100 Back X-Ray/3 view (based on medical history) $ 70.00
23. 71020 Chest X-ray, 2 view (If positive PPD) $ 65.00
24. 94150 Spirometry (Based on medical questionnaire) $ 35.00
25. 207249 Form Completion (DMV) if needed $ 25.00
26. 99000 DOT Drug Screen Collection Bill to TPA
(National Safety)
27. Visit Category #4 Residential Rehabilitation
Position
28. 207251 Pre-placement Physical Exam $ 65.00
(includes: medical history,
vitals, height, weight, hearing check (whisper test) visual
screen (color/far/near)
29. 86580 PPD, Step 1 $ 20.00
30. Frequently lift 50 pounds or more. Included in
examination
31. 80100Rapid Quick Test (Non-DOT Drug Screen) Bill to TPA
(Preferred Alliance)
32. Fit Test for N95 mask $ 35.00
33. 99358 Review of Respiratory Questionnaire $ 35.00
34. Zpp (Lead in blood cells, based on medical $ 35.00
questionnaire)
35. 83655 Lead in blood (Based on medical questionnaire). $25.00
36. 36415 Venipuncture (blood draw) $ 15.00
Optional:
37.
38. 72100 Back X-Ray/3 view (based on medical history) $ 70.00
39. 71020 Chest X-ray, 2 view (If positive PPD) $ 65.00
40. 94150 Spirometry (Based on medical questionnaire) $ 35.00
41. 207249 Form Completion (DMV) if needed $ 25.00
42. 99000 DOT Drug Screen Collection Bill to TPA
(National Safety)
43. 80048 Chem Panel 2-7 (Based on medical questionnaire) $24.00
44. 85025 Complete Blood Count w/diff (Based on medical $15.00
questionnaire)
45. Visit Category # 5 Police Exam – Pre-placement
46. 99499 POST Exam $ 95.00
(includes: medical history, vitals, height,
weight, hearing check (whisper test) visual screen
(color/far/near)
47. 92552 Audiogram $ 30.00
48. 94150 Spirometry $ 35.00
49. 93000 EKG (resting) $ 50.00
50. 93015 Cardiac stress test with Treadmill $ 230.00
51. 86580 PPD, Step 1 $ 20.00
52. 85025 Complete Blood Count $ 15.00
53. 80053 Chem Panel 8-23 $ 35.00
(ALT(SGPT), AST(SGOT), Creatinine, Fasting
Glucose, AlkPhos, Potassium(K),Sodium(Na), Urea Nitrogen(BUN), LIPID
PANEL (LDL, Cholesterol, HDL, Triglycerides)
54. 86706 Hepatitis B Surface Antibody $ 31.00
55. 86803 Hepatitis C Antibody screen $ 45.00
56. 86735 Mumps Antibody Titer $ 35.00
57. 86762 Rubella Antibody Screen $ 35.00
58. 86765 Rubeola Antibody Screen $ 35.00
59. 86787 Varicella Antibody Screen $ 35.00
60. 80100 Rapid Quick Test (Non-DOT Drug Screen) Bill to TPA
(Preferred Alliance)
61. 81001 Urinalysis w/micro (indicate protein/sugar) $15.00
62. 36415 Venipuncture (blood draw) $15.00
63. 90715 TdaP (Tetanus) $ 40.00
64. Optional:
65. 90746 Hepatitis B Vaccine injection, one dose per injection $ 65.00 each
(Series of 3)
66. 71020 Chest X-ray, 2 view (If positive for PPD) $ 65.00
67. 90707 MMR Injection $ 59.00
68. 90716 Varicella vaccine injection $ 80.00
69. Visit Category # 6 Police – Annual/Baseline
Examination
70. 99499 POSTExam $ 95.00
(includes: medical history, vitals, height,
weight, hearing check (whisper test) visual screen
(color/far/near)
71. 92552 Audiogram $ 30.00
72. 94150 Spirometry (based on medical history)$ 35.00
73. 86580 PPD, Step 1 $ 20.00
74. 93000 EKG (resting) $ 50.00
75. 85025 Complete Blood Count $ 15.00
76. 80053 Chem Panel 8-23 $ 35.00
(ALT(SGPT), AST(SGOT), Creatinine ,Fasting
Glucose, AlkPhos, Potassium(K),Sodium(Na), Urea Nitrogen(BUN), LIPID
PANEL (LDL, Cholesterol, HDL, Triglycerides)
77. 36415 Venipuncture (blood draw) $ 15.00
78. 86706 Hepatitis B Surface Antibody $ 31.00
79. 86803 Hepatitis C Antibody screen $ 45.00
80. 86735 Mumps Antibody Titer $ 35.00
81. 86762 Rubella Antibody Screen $ 35.00
82. 86765 Rubeola Antibody Screen $ 35.00
83. 86787 Varicella Antibody Screen $ 35.00
84. 81001 Urinalysis w/micro $ 15.00
85. 90715 TdaP (Tetanus) $ 40.00
Optional
86.
87. 71020 Chest X-ray – 2 view (if positive PPD) $ 65.00
88. 93015 Cardiac stress test with Treadmill (over 45) $ 230.00
89. 90746 Hepatitis B Vaccine injection, one dose per injection $ 65.00 each
(Series of 3)
90. 90707 MMR Injection $ 59.00
91. 90716 Varicella vaccine injection $ 80.00
92. 84152 PSA (beginning at age 45 and every year thereafter) $ 53.00
93. 82270 Occult Blood (fecal) beginning at age 45 $ 20.00
94. Visit Category # 7 Firefighter Exam–Pre-placement
95. 99499 Firefighter Physical Exam $ 95.00
(includes: medical history,
vitals, height, weight, hearing check (whisper test) visual
screen (color/far/near)
96. 92552 Audiogram $ 30.00
97. 94150 Spirometry $ 35.00
98. 93000 EKG $ 50.00
99. 93015 Cardiac Stress test with treadmill $ 230.00
100. 86580 PPD, Step 1 $ 20.00
101. 85025 Complete blood count $ 15.00
102. 80053 Chem Panel 8-23 $ 35.00
(ALT(SGPT), AST(SGOT), Creatinine ,Fasting
Glucose, AlkPhos, Potassium(K),Sodium(Na), Urea Nitrogen(BUN), LIPID
PANEL (LDL, Cholesterol, HDL, Triglycerides)
103. 86735 Mumps Antibody Titer $ 35.00
104. 86762 Rubella Antibody Screen $ 35.00
105. 86765 Rubeola Antibody Screen $ 35.00
106. 86787 Varicella Antibody Screen $ 35.00
107. 86706 Hepatitis B Surface Antibody $ 31.00
108. 86803 Hepatitis C Antibody Screen $ 45.00
109. 36415 Venipuncture (blood draw) $ 15.00
110. 81001 Urinalysis, w/micro $ 15.00
111. 80100 Rapid Quick Test (Non-DOT Drug Screen) Bill to TPA
(Preferred Alliance)
112. 90715 TdaP (Tetanus) $ 40.00
Optional:
113.
114. 71020 Chest X-ray 2 view (If positive PPD) $ 65.00
115. 90746 Hepatitis B Vaccine injection, one dose per injection $ 65.00 each
(Series of 3)
116. 90907 MMR Injection $ 59.00
117. 90716 Varicella vaccine injection $ 80.00
118. 207249 Form Completion (DMV) if needed $ 25.00
Visit Category #8 Firefighter Annual/Baseline
119.
Examination
120. 99499 Firefighter Physical Exam $ 95.00
(includes: medical history,
vitals, height, weight, hearing check (whisper test) visual
screen (color/far/near)
121. 92552 Audiogram $ 30.00
122. 94150 Spirometry $ 35.00
123. 86580 PPD, Step 1 $ 20.00
124. 85025 Complete Blood Count $ 15.00
125. 80053 Chem Panel 8-23 $ 35.00
(ALT(SGPT), AST(SGOT), Creatinine ,Fasting
Glucose, AlkPhos, Potassium(K),Sodium(Na), Urea Nitrogen(BUN), LIPID
PANEL (LDL, Cholesterol, HDL, Triglycerides)
126. 81001 Urinalysis, w/micro $ 15.00
127. 93000 EKG $ 50.00
128. 36415 Venipuncture (blood draw) $ 15.00
129. 90715 TdaP (Tetanus) $ 40.00
130. 86706 Hepatitis B Surface Antibody $ 31.00
131. 86803 Hepatitis C Antibody screen $ 45.00
132. 86735 Mumps Antibody Titer $ 35.00
133. 86762 Rubella Antibody Screen $ 35.00
134. 86765 Rubeola Antibody Screen $ 35.00
135. 86787 Varicella Antibody Screen $ 35.00
136. Optional:
137. 71020 Chest X-ray, 2 view (If positive PPD) $ 65.00
138. 84152 PSA (beginning at age 45 and every year thereafter) $ 53.00
139. 82270 Occult Blood (fecal) beginning at age 45 $20.00
140. 93015 Cardiac Stress Test w/treadmill 45 and over $ 230.00
141. 90746 Hepatitis B Vaccine injection, one dose per injection $ 65.00 each
(Series of 3)
142. 90707 MMR Injection $ 59.00
143. 90716 Varicella vaccine injection $ 80.00
144. 207249 Form Completion (DMV) $ 25.00
145. Visit Category #9
146. 207249 Form Completion (DMV) if needed $ 25.00
Visit Category #10 Drug Screen
147.
148. 99000 DOT Drug Screen Collection (DOT Random, RTW, Bill to TPA
Follow-up, Reasonable Suspicion) (National Safety)
149. 80100 Non-DOT Rapid Quick Test Drug Screen (Reasonable Bill to TPA
Suspicion(Preferred Alliance)
)
Visit Category # 11 Breath Alcohol
150.
151. 82075 DOT Breath Alcohol Test (DOT Random, RTW, Follow-Bill to TPA
up, Reasonable Suspicion) breath analyzer (National Safety)
152. 82075 Non-DOT Breath Alcohol Test (Reasonable Suspicion) Bill to TPA
breath analyzer (Preferred Alliance)
153. Visit Category #12 Fitness for Duty Evaluation
154. 99499ZD Fitness for DutyEvaluation (Return to Work)$ 95.00
155. 99499ZD Physician Consultation, one hour (fitness for duty) $ 240.00
156. 99499ZD Physician Consultation, each additional $ 60.00
15 minutes (fitness for duty)
If CITY OF DOWNEY OHSS is requesting a health screening/physical examination of a job applicant/employee,
CITY OF DOWNEY OHSS will provide to SCPMG detailed information concerning the physical requirements for
performing the job at issue. This information should include a written job description, including physical and mental
requirements and environmental conditions. The examination and any medical conclusions will be based on the
information furnished by CITY OF DOWNEY OHSS and the physician’s general understanding of the requirements
of the jobs of similar nature. SCPMG conducts such examinations with CITY OF DOWNEY OHSS’s assurances
that the examination and CITY OF DOWNEY OHSS’s medical inquiries are job-related and consistent with the
business needs of CITY OF DOWNEY OHSS, and otherwise comply with all applicable legal obligations.
Based on its health screening/physical examination of a job applicant/employee, SCPMG will advise CITY OF
DOWNEY OHSS of the following: a) the applicant/employee’s physical limitations, if any, and the specific job tasks
that cannot be performed and/or environmental conditions, if any, that are related to any risk to health and safety,
and b) changes that may be made to permit the job tasks to be performed and/or eliminate/reduce the risk. SCPMG
will make no determination of whether job tasks are essential to the position in question. Any changes that are
recommended are advisory only, based on the physician’s general understanding of the job and environment in
question, and are not intended to supplant the right of CITY OF DOWNEY OHSS to determine what modifications
are available and reasonable.
To the extent that other conditions are identified, SCPMG will also: a) notify the employee/applicant of any medical
condition, identified during the limited medical evaluation that CITY OF DOWNEY OHSS requested, that SCPMG
believes requires further attention, and recommend that the employee/applicant seek care from his or her personal
provider, thereby encouraging health and wellness, leading to a more productive workforce, and b) upon
authorization of the employee/applicant, SCPMG will inform his or her personal medical provider by transmitting
copies of the medical records created during the visit.
SCPMG will maintain a medical record, for each individual that will contain records of employer requested services,
in addition to past, present and future services requested by the employee/applicant.