City_Wide_Occupational_Health_Services_(Addendum_#1_Revision).pdf

CITY OF TUCSON

REQUEST FOR PROPOSAL

240140

CITY WIDE OCCUPATIONAL HEALTH SERVICES

Due Date: Thursday, September 19, 2024

City of Tucson

255 W Alameda St

Tucson, AZ 85701

Procurement portal https://secure.procurenow.com/portal/tucson-az

Public Portal https://secure.procurenow.com/portal/tucson-az/projects/111531

PUBLISH DATE: August 22, 2024 https://secure.procurenow.com/portal/%7Bproject.government.code%7D https://secure.procurenow.com/portal/%7Bproject.government.code%7D/projects/%7Bproject.id%7D https://secure.procurenow.com/portal/%7Bproject.government.code%7D/projects/%7Bproject.id%7D

CITY OF TUCSON REQUEST FOR PROPOSAL NO. 240140

BUSINESS SERVICES DEPARTMENT Page 2 of 60 SHARED SERVICES PROCUREMENT DIVISION RESPONSIBLE CONTRACT OFFICER: Troy Rombough

255 W. ALAMEDA, 6TH FLOOR, TUCSON, AZ 85701 PH: (520) 837-4139

Attachments:

A - Offer and Acceptance E - WSV_for_Non-Work_Injuries F - Affidavit_of_Correction_Form

BUSINESS SERVICES DEPARTMENT Page 3 of 60

A. NOTICE

A.1. CITY OF TUCSON

NOTICE OF REQUEST FOR PROPOSAL NO 240140

TITLE: City Wide Occupational Health Services

SUBMITTAL DUE DATE: Thursday, September 19, 2024 AT 2:00 P.M. LOCAL AZ TIME

PRE-SUBMITTAL CONFERENCE DATE: Thursday, August 29, 2024

TIME: 9:00 am LOCAL AZ TIME

LOCATION: Microsoft Teams https://teams.microsoft.com/l/meetup-join/19%3ameeting_MTg1ZmU0YWQtM2NhZi00MGMxLWJiYjQtOWFkZDYzYjFhOTJi%40thread.v2/ 0?context=%7b%22Tid%22%3a%22d21e59ec-c208-43eb-aaf1-cf06d9a196e0%22%2c%22Oid%22%3a%22b805a639-d2eb-45cf-98f6-49ad7eee5cc0%22%7d

QUESTIONS SHALL BE DIRECTED TO: Troy Rombough

(520) 837-4139 troy.rombough@tucsonaz.gov

Posted Date: Thursday, August 22, 2024

Competitive sealed offers for the material or service specified in this solicitation must be submitted through the City’s online bidding system. No late submitted offer will be accepted or considered.

Reponses submitted in physical form or by facsimile or email will not be considered. Offerors are cautioned to commence the submittal process sufficiently ahead of time to allow for unanticipated delays resulting from things like a slow internet connection, internet outage, difficulty uploading large documents, differing system requirements, etc.

Questions about this solicitation must be addressed to the responsible Contract Officer listed herein.

BUSINESS SERVICES DEPARTMENT Page 4 of 60

B. INTRODUCTION

B.1. Summary

The City of Tucson, (hereafter referred to as ‘City’) is seeking proposals for the provision of occupational health services and evaluation and treatment of the following services for city employees:

GROUP - A: OCCUPATIONAL MEDICINE- Medical Examination, Surveillance and Monitoring, Post- Offer Physicals, DOT Commercial Driver's License Medical Examination, Asbestos Medical Examination, Respirator Use Medical Examination, Drug & Alcohol Testing, Vaccinations, Audiometric Testing, Fitness for Duty evaluations, return to work evaluations, and Workers Compensation Services.

GROUP - B: BEHAVIORAL HEALTH SERVICES- Mental Health Counseling/Psychotherapy, Mental Health Chemical Dependency/Addiction Counseling

The City intends to award by group and may award to one or more suppliers per group. The offeror may submit to one or both groups.

B.2. Contact Information

Troy Rombough Principal Contract Officer Email: troy.rombough@tucsonaz.gov Phone: (520) 837-4139 Department:

Business Services mailto:troy.rombough@tucsonaz.gov tel:(520)837-4139

BUSINESS SERVICES DEPARTMENT Page 5 of 60

C. SCOPE OF WORK

C.1. GROUP - A: Occupational Medicine

The following are general requirements for All City Employees:

A. Contractor must have a Board Certified Occupational Medicine physician licensed in the state of Arizona

B. Medical Providers will maintain appropriate licenses, certifications, designations, and/or registrations to ensure medical services comply with the Department of Transportation (DOT) and Department of Labor requirements.

C. Contractor must be located in Tucson, Arizona and surrounding areas. Medical Facility is adequately staffed and maintains sufficient hours of business to meet the City's needs.

D. Medical services for all City employees are to be performed in accordance with professional medical standards by a duly licensed physician with the exception of routine components of an examination which may be performed by qualified support personnel under the supervision of a licensed physician. Services may also be provided by a licensed and certified Nurse Practitioners and/or Physician’s assistant under the supervision of a licensed Physician and in consultation with the medical director/assigned licensed physician on staff at each location.

E. Medical Facility is adequately staffed and maintains sufficient hours of business to meet City of Tucson needs, as outlined in the scope of work.

F. Contractor must verify photographic identification of all employees/candidates prior to rendering services.

G. Contractor must date and time stamp all employees in and out time for any services.

H. Contractor must provide the designated City Group Contract Representative with the preliminary results of the examination on the same day, and no later than the next business day with the exception of pre-employment drug test results, or other specified examinations requiring additional time.

I. Final results of examinations and/or testing shall be provided to the designated City Group Contract Representative within three (3) business days from date of examination or test.

BUSINESS SERVICES DEPARTMENT Page 6 of 60

J. When a work status is required for the type of services rendered, Contractor must always address the work status, and/or recommendations in the following manner:

o Employee can perform the essential functions of the position without restriction.

o Employee restrictions must be specified with exact parameters, including the time frame of the specified restrictions.

o Employee can perform the essential functions of the position with restriction(s). Restrictions must be specified, including whether or not they are permanent, if known.

o Employee cannot perform the essential functions of the position.

o In cases where a determination cannot be made on the same day of the examination/evaluation because additional information is required from the employee’s personal health care provider, the designated City Group Contract Representative and the employee will be provided with a work status that will address the employee’s ability to safely and effectively perform job duties to include the operation of equipment and will remain in effect until the additional information required or requested is received and reviewed by the Contractor at which time a final recommendation must be made to the City. Examples shall be “off work – pending review,” or “restricted duty – pending review.”

o Contractor must provide the work, status and/or recommendations on a form approved by the City. The form must be provided to the employee upon completion of the examination before the employee leaves the premises. The form must also be provided to the designated City Group Contract Representative on the same day of the examination in a method agreed upon by the City and the Contractor.

o Contractor must maintain permanent files on each employee/candidate examined, which may include, but are not limited to: Health History Questionnaire, Report of Medical Examination, Laboratory Records, X-Rays and other related documentation as per the Arizona Retention Schedule.

o Contractor must maintain an operational capability that will, under normal circumstances, provide for the scheduling of examinations within three (3) working days from date of request.

o Contractor must assist the City in developing and reviewing applicable tests for job classifications as requested by the City.

K. Contractor will immediately notify Risk Management when medical facilities cannot meet the testing protocols for any length of time (i.e. broken equipment)

L. Contractor will notify the appropriate City department representative within 24 hours if any employee misses or reschedules an appointment. Missed appointment notifications will be communicated in writing at the end of the business week.

M. Contractor agrees to provide research and consultative services to the City when required. For example, the City may require information relating to the relative toxicity of certain chemicals, on work procedures used by the City employees, or reasonable work accommodations. However, the City does

BUSINESS SERVICES DEPARTMENT Page 7 of 60 not expect this advice to take the place of an independent Certified Industrial Hygienist. Contractor agrees to the first 24 hours of consultative services to be provided at no charge/cost.

N. The contractor must be available to respond via phone, email, or faxed communication when clarification is needed. If not available the contractor will respond within one (1) to two (2) Business days.

C.2. PRE-EMPLOYMENT PHYSICAL EXAMINATIONS

A. Pre-employment physical examinations will be conducted in accordance with this Contract and instructions from the applicable Group’s Contract Representative. Contractors will assure that all examinations will include all components requested by the City.

B. Contractor will provide DOT Certified Physicians to provide DOT exams.

C. Contractor will provide services to current employees and candidates for employment with the City who produce written authorization of services and a copy of their job classification description. The written authorization for services will be provided on a City form which also requires, (at a minimum), preliminary results. The form must be signed and dated by the physician and returned to the designated City Group Contract Representative on the same day of the evaluation in a method agreed upon by the City and the Contractor. Services may also be provided by certified Nurse Practitioners and/or Physician’s assistants licensed in the state of Arizona.

D. Pre-employment physical examinations may include but are not limited to:

1. Review of job classification for physical requirements for the position and a Health Questionnaire, if applicable (Questionnaire forms to be provided by Contractor)

2. Medical History provided by the patient

3. Physical examination

4. Objective spinal testing to include flexibility and lifting

5. Drug Test

6. Laboratory tests as agreed upon by the City and the Contractor for the type of Pre-employment physical being requested

BUSINESS SERVICES DEPARTMENT Page 8 of 60

7. X-rays

8. Pulmonary Function Test (PFT)

9. Audiogram – Examination will be performed in accordance with 29 CFR 1910.95 With respect to annual audiogram testing, all Standard Threshold Shifts (STS) shall be reported as soon as feasibly possible to the designated City Group Contract Representative.

10. Asbestos Medical Examination - Examination will be completed in accordance with 29 CFR 1926.1101.

11. Respirator Use Medical Examination. Examinations will be completed in accordance with 29

CFR 1910.134.

E. Determination of the employee/candidate’s ability to perform in the position for which they are being evaluated will be provided as described in the All City Employee section (Section 1) of this Scope of Work.

F. Any procedures other than routine pre-employment procedures require prior authorization from the applicable Group Contract Representative.

G. Contractor will maintain physical custody of all medical records. Medical records may include, but are not limited to: medical history questionnaire, long audio test results, drug test results, laboratory records, x-rays, documentation or proof of vaccinations or immunizations, and other related documentation.

C.3. RETURN TO WORK EXAMINATIONS

Employees who meet the criteria defined in the current City Administrative Directives may be required to have a return to work evaluation. Contractor will evaluate the employee’s ability to return to work in their assigned position.

A. When the Contractor requires medical information from the employee’s health care provider to make the determination of work status, it is the Contractor’s responsibility to obtain a signed release of medical records from the employee and obtain the information telephonically from their health care provider or provide the employee with a written request for pertinent medical information needed to complete the evaluation.

BUSINESS SERVICES DEPARTMENT Page 9 of 60

B. If the Contractor needs additional information on the employee’s assigned position in order to complete the evaluation, Contractor will obtain the job description from the City of Tucson Website or call the City to obtain a copy of the job description. Measuring and validating each job's essential and non-essential tasks with standardized frequency and duration measurements.

C. Diagnostic testing or medical treatment of the condition will not be performed by the Contractor to determine the work status of the employee.

D. Determination of the employee/candidate’s ability to return to work in their assigned position will be provided as described in the All City Employee section (Section 1) of this Scope of Work.

E. The work status must be provided to the employee upon completion of the examination, before the employee leaves, and also to the designated City Group Contract Representative.

C.4. WORK STATUS VERIFICATION EXAMINATIONS

Employees who request light duty for non-industrial conditions may be required to have a work status verification evaluation.

A. Contractor will evaluate the employee, along with any applicable information from their health care provider, to make the determination of their work status. The contractor will collect information from the employee's healthcare provider before determining work status (for non-industrial) when the employee is being seen by their own provider and has documentation/recommendations from their personal health care provider.

B. If the physician needs additional information on the employee’s assigned position in order to complete the evaluation, Contractor will obtain the job description from the City of Tucson website or call the City to obtain a copy of the job description.

Contractor to determine the work status of the employee.

D. The work status recommendations will be provided as described in the All City Employee section (Section 1) of this Scope of Work.

BUSINESS SERVICES DEPARTMENT Page 10 of 60

E. The work status must be provided to the employee upon completion of the examination, before the employee leaves, and also to the City and the Group Contract Representative.

F. For non-work related evaluations, Contractor will not forward a report containing the employee’s condition or diagnosis, but will keep that information in their permanent records per HIPAA requirements.

C.5. CITY PHYSICIAN MEDICATION CLEARANCE EXAMINATION

A. Employees who meet the criteria defined in the current City Administrative Directives may be required to have a medication clearance examination for prescription and/or non-prescription medications. In most cases, these evaluations are telephonic; however, in the event additional evaluation is necessary, Contractor will work with the designated City Group Contract Representative to arrange a medical examination.

o The City will provide the Contractor with contact information and a job description for the employee. The form must be signed and dated by the physician and returned to the designated City Group Contract Representative on the same day of the evaluation in a method agreed upon by the City and the Contractor.

B. The Contractor will call the employee for the telephonic evaluation on the same day of the request.

The physician will complete the City form which requires at a minimum preliminary results and recommendations as described in the All City Employee section (Section 1) of this Scope of Work.

C. The contractor will then provide the form to the City on the same day of the evaluation in a method agreed upon by the City and the Contractor.

C.6. FITNESS FOR DUTY EXAMINATIONS

Contractor will perform Fitness for Duty examinations only at the City’s request. Fitness for Duty examinations will be pre-scheduled by the Leaves and Accessibility group only and are limited to job related factors consistent with the assigned position of the employee.

A. The City will provide the contractor with: a cover letter, copy of the job description, documented concerns of the employee’s ability to perform in their assigned position, and any job specific questions to address.

B. The Contractor is responsible determining what additional information is needed in order to complete the examination. When the Contractor requires medical information from the employee’s health care provider, it is the Contractor’s responsibility to obtain a signed release of medical records from the employee and obtain the information telephonically from the

BUSINESS SERVICES DEPARTMENT Page 11 of 60 provider or provide the employee with a written request for pertinent medical information needed to complete the evaluation.

C. The Contractor’s recommendations will be provided as described in the All City Employee section (Section 1) of this Scope of Work.

D. In cases where a determination cannot be made on the same day of the appointment, the designated City Group Contract Representative and employee will be provided with a “pending review” work status such as “off work – pending review,” or “restricted duty – pending review.” This work status will address the employee’s safe ability to remain in the work place and will remain in effect until the additional information needed is received by the Contractor.

E. Fitness for Duty examinations completed in one visit does not require a narrative report.

F. Fitness for Duty examinations requiring additional information from the employee and/or their health care provider(s) require a typed narrative report indicating the reason for the delay/”pending review” status. i.e. pending review status, but detailed medical information shall not be included in the report provided to the Leaves and Accessibility group.

G. The report must be provided to the designated City Group Contract Representative within three (3) business days in a method agreed upon by the City and the Contractor.

Diagnostic testing or medical treatment of the condition will not be performed by the Contractor to determine the employee’s fitness for duty.

C.7. DRUG AND ALCOHOL TESTING

The City has job classifications which require drug and/or alcohol testing. Every employee who operates a commercial motor vehicle as an essential function of their job will be subject to drug and alcohol testing per DOT/FMCSA regulations. Random drug and alcohol screening is also required for safety sensitive positions. A list will be provided of those employees selected for random drug & alcohol testing to the contractor on a monthly basis.

Drug and alcohol testing may be required for:

• Pre-employment physicals

• Random Testing (to be conducted monthly throughout the calendar year)

• Reasonable Suspicion

• Post-Accident

• Return to work

BUSINESS SERVICES DEPARTMENT Page 12 of 60

• Follow-up

A. For Reasonable Suspicion and Post-Accident Drug testing the Contractor will follow the Protocols as listed.

A. For reasonable suspicion, the employee will be brought back for the Breath Alcohol Test (BAT) and testing within 15 minutes from arrival to clinic, and the testing begin within 30 minutes from arrival.

B. For post-accident drug testing the employee will be brought back for the BAT and testing within 15 minutes from arrival to clinic, and the testing begin within 30 minutes from arrival.

B. All drug and alcohol testing requires authorization from the designated employer representative (DER).

C. Breath Alcohol Testing shall be performed using machines approved and calibrated by the appropriate regulatory body, by certified technicians. Calibration reports and technician certifications must be made available to the City upon request.

D. Contractor is responsible for notifying the attending supervisor/escort when the test is complete prior to dismissing the employee.

E. In the event an employee leaves the facility prior to completion of the test, Contractor must notify the designated City Group Contract Representative and designated employer representative (DER), in a method agreed upon by the City and the Contractor.

F. Contractor will provide Medical Review Officer “MRO” services as required under the Federal Motor Carrier Safety Administration Regulations for CDL operators and safety sensitive positions.

G. All Non-DOT drug and alcohol testing will be conducted utilizing Non-federal/Non-USDOT custody and control forms (CCFs) and alcohol testing forms (ATFs). In the event a collector uses a non-Federal form or expired Federal form for the drug test, the flaw may be corrected by providing a signed Certificate of Correction memorandum for the record stating the incorrect form contains all the information needed for a valid DOT drug test, and the incorrect form was used inadvertently or as the only means of conducting a test, in circumstances beyond the collector’s control. The MFR (Memorandum for Record) must also list steps taken to prevent future use of non-Federal or expired forms for DOT tests. The Collector must supply this Certificate of Correction to the Medical Review Officer (MRO), and DER, on the same business day on which you were notified of the problem, transmitting it by fax or courier. The collector must maintain this memorandum with the original Chain of Custody form (CCF) and must also mark the CCF in such a way as to make it obvious on the face of the CCF that the flaw was corrected. In order for this flaw to be corrected, the urine specimen must have been tested at an HHS-certified laboratory consistent with the requirements of 49 CFR Part 40. If this flaw is NOT corrected, the MRO will cancel the test.

H. In the event a collector uses an expired CCF, or incorrectly marks the reason for testing, an affidavit of correction must be submitted to the City of Tucson DER. In the event a Breath Alcohol Technician (BAT) is unable to obtain the printed result of a breathalyzer test, The BAT must provide a signed statement, on agency letterhead, certifying that they fully understand the requirements that if the device is one that does not print the test number, testing device

BUSINESS SERVICES DEPARTMENT Page 13 of 60 name and serial number, time, and result, or it is a device not being used with a printer, you must record this information in Step 3 of the ATF. Additionally, the BAT must attest to the fact that the ATF explicitly states in Step 3 that the results are only to be handwritten if the EBT is not designed to print.

I. Additionally, the BAT must provide a signed statement, on agency letterhead, certifying that they have fully understand the requirements that the BAT must only sign Step 3 of the ATF after the result has been obtained.

J. The BAT must provide a signed statement certifying that they fully understand the requirements that the BAT must open a new individually wrapped or sealed mouthpiece in view of the employee for the confirmation test.

K. The BAT must observe the 15-minimum waiting period prior to conducting the confirmation test. In the event the 15-minute waiting period is not followed, The BAT must provide a signed statement, on agency letterhead, stating that they fully understand the requirements that it is a fatal flaw, and would cause the test to be canceled, if the BAT does not observe the 15-minute minimum waiting period prior to conducting the confirmation test.

L. If the Evidential Breath Test (EBT) device produces two consecutive air blank readings greater than 0.00 before a confirmation test, The BAT must provide a signed statement, on agency letterhead, certifying that they fully understand the requirements that if the air blank reading is greater than 0.00 on two consecutive air blank tests prior to a confirmation test, the BAT must take the EBT out of service.

M. The collector must always direct the employee to empty his/her pockets and display items to ensure no items are present which could be used to adulterate the specimen. In the event this step is skipped/missed, The Collector must provide a signed, Certification of Correction, certifying that they fully understand the requirements that the collector must always direct the employee to empty his or her pockets and display the items to ensure that no items are present which could be used to adulterate the specimen. and send completed Certificate of Correction to the DER.

N. The collector must explain/describe the procedures required for a directly observed collection.

This encompasses the employee to raise his or her shirt, blouse, or dress/skirt, as appropriate, above the waist; and lower clothing and underpants to show by turning around, that they do not have a prosthetic device. After you have determined that the employee does not have such a device, you may permit the employee to return clothing to its proper position for observed urination. As the observer, you must watch the employee urinate into the collection container.

Specifically, you are to watch the urine go from the employee's body into the collection container. As the observer but not the collector, you must not take the collection container from the employee, but you must observe the specimen as the employee takes it to the collector.

O. Collector must obtain a sufficient specimen within three hours of the first unsuccessful attempt by the employee to provide the specimen. In the event the time lapse is three hours or greater, the collector must discontinue the collection, note the fact on the "remarks" line of the CCF, and immediately notify the Designated Employer Representative (DER).

P. The technician is required to explain or show the employee the instructions on the back of the Alcohol Test Form (ATF) at the beginning of the testing process.

BUSINESS SERVICES DEPARTMENT Page 14 of 60

Q. The technician is required to accurately describe the required actions or allowable activities to an employee during the 15-minute waiting period (e.g. don’t put anything into their mouth). In the event the employee does not follow the required actions, The BAT must provide a signed statement certifying that they have read and fully understand the requirements of 49 CFR Part 40.251(a)(3) which states if the BAT becomes aware that the employee has not followed the instructions during the 15-minute wait period, the BAT must note this on the Remarks line of the ATF.

R. All BATs must be signed up for USDOT-ODAPC’s List-Serv.

S. The Collector must explain the basic collection procedure to the employee or show the employee the instructions on the back of the CCF at the beginning of the testing process.

T. The Collector must direct the employee to read and complete Step 5 on Copy 2 of the CCF prior to the collector completing Step 4 on Copy 1 of the CCF.

U. In the event the collector finds any material that could be used to tamper with a specimen, the collector must determine if the material appears to have been brought to the collection site with the intent to alter the specimen, and, if it has, conduct a directly observed collection using direct observation procedures.

V. If the employee admits to the collector or the MRO to having adulterated or substituted the specimen, the Collector must provide a written signed statement, on agency letterhead, on the same day, of what the employee told them and submit it to the DER.

W. In the event an employee provides an initial sample which is adulterated or out of temperature range, and also provides a second specimen under direct observation, both specimens must be processed and sent to the laboratory.

X. Contractor will provide random selection services for two drug and alcohol testing pools (CDL and COT Safety Sensitive). The City will provide the pool of candidates to the Contractor in .xls or .xlsx (Excel) format. The Contractor shall use automated randomizing software to perform the selection. Test pool requirements will follow FMCSA regulations. The random selections will be provided to the City of Tucson DER within 48 hours.

Y. Blood Alcohol Draw may be requested by any employee who shows presence of breath alcohol above the City’s levels as defined in the City of Tucson Administrative Directives. This includes after-hours testing.

Z. Contractor must be available for random, post-accident, and reasonable suspicion drug and/or alcohol testing as scheduled/required to include after-hours (5P-8A) 7 days/week.

AA. Contractor must notify City of Tucson DER, or Risk Management/Safety when an employee presents to a clinic for drug and alcohol testing without an authorized clinic form.

BB. Contractor will keep the City informed of FMCSA compliance rules or guidelines changes that could affect the City physician's authorization of CDL physical requirements. If there are significant changes to FMCSA medical compliance guidelines, the Contractor will agree to work with Human Resources to hold update meeting(s) with City Employees to discuss the changes.

CC. Contractor will submit a biannual report to City of Tucson DER of all employees who have been drug or alcohol tested throughout the year. The report will have the following

BUSINESS SERVICES DEPARTMENT Page 15 of 60 information: Employee Name, Department, Specimen ID#, Chain of Custody#, Last 4 of SSN or COT EID#, Collection Date, Collection Time, Final Verification Date, Type of Test (Pre- Employment, Random, Post-Accident, etc.), Result, Diluted (Y/N), Clinic Location.

DD. Contractor will abide by the Federal calibration schedule for BAT maintenance and will provide compliance documentation upon request from the City.

EE. Contractor will only use Health and Human Services-certified laboratories.

FF.Contractor will use certified Breath Alcohol Urine Collection Technicians and Medical Review Officers that have been trained in accordance with 49 CFR, Part 40 (USDOT Drug and Alcohol Testing Regulation) and provide certifications of such training to the City annually. In the event the City experiences compliance issues as they relate to the drug and alcohol testing protocol as a whole, the City will require Affidavits of Correction to be completed. Repeated issues will warrant retraining of the contractor’s technicians by the contractor. and certifications of such training to be provided to the City's DER.

GG. In the event of a reported negative-dilute specimen with a creatinine concentration greater than or equal to 2 mg/dL but less than or equal to 5 mg/dL, a second collection must take place under direct observation. It will be the Contractors responsibility to call the employee to have them return for the new test.

HH. Tests for breath alcohol concentration will be conducted utilizing a NHTSA-approved Evidential Breath Testing device operated by a trained Breath Alcohol Technician. Alcohol tests performed using a non-evidential testing device which indicate an alcohol concentration of .02 or greater, will be required to have a second test done no sooner than 15 minutes after the completion of the initial test. Should the second test results be greater than .02, then the DER should be called.

II. Contractor may not redirect employee services to another location or lab once the employee presents at the location for a drug and/or alcohol test. In the event the contractor is unable to fulfill its duty and responsibility as a service provider of drug and/or alcohol testing, it must immediately notify the DER and City Group Contract Representative.

JJ. If the drug test is positive, the MRO must call the DER to report a positive drug test as soon as possible. The MRO at the time of the consulting phone call to the employee will offer the split sample to be tested and explain this process to the employee. The MRO must provide the time the split sample was offered and the time the split sample was accepted or declined, to the DER.

C.8. DOT EXAMINATIONS AND CDL MEDICAL RE-CERTIFICATIONS

Contractor will provide examinations by a Department of Transportation (DOT) certified physician in accordance with Federal Motor Carrier Safety Administration Regulations for CDL operators.

A. If Contractor requires additional medical information to complete the examination, it is the Contractor’s responsibility to provide the employee with a written request to provide to the employee/candidate’s health care provider. The request will outline what medical information is needed to complete the evaluation.

BUSINESS SERVICES DEPARTMENT Page 16 of 60

B. Diagnostic testing or medical treatment of the condition will not be performed by the Contractor to determine the medical clearance.

C. The Contractor will notify the DER and the City Group Contract Representative of any DOT medical clearances in a pending status.

D. The Contractor will make available to City employees that privately hold a CDL endorsement, the contracted COT DOT Exam price. The employee must pay for the service. For self-paid non-work related DOT physicals, the Contractor will not forward the DOT clearance reports to the City.

C.9. SURVEILLANCE PHYSICALS

Contractor will perform surveillance physicals including, but not limited to:

o Asbestos o Audiometric – with respect to annual audiograms, all STSs shall be reported as soon as feasibly possible to the designated City Group Contract Representative o Biological monitoring (metals, pesticides, radiation and exposures) o HazMat o Respirator

A. Contractor will be responsible for comparing previous results with current results and notifying the Group Contract Representative of changes or shifts.

B. If Contractor requires medical information from the employee’s health care provider, it is the Contractor’s responsibility to obtain a signed release of medical records from the employee and/or provide the employee with a written request to provide to the employee/candidate’s health care provider. The request will outline what medical information is needed to complete the physical.

Contractor to determine the medical clearance.

C.10. EVALUATION AND TREATMENT OF INDUSTRIAL INJURIES

Contractor will comply with the Arizona Workers Compensation Laws and Rules. Evaluation and treatment of all city employees will be performed by a duly licensed physician.

BUSINESS SERVICES DEPARTMENT Page 17 of 60

The requirement set fourth in this scope of work are based on requirements current as of the release of the solicitation. If requirements change based on promulgation of new standards, modifications to existing standards, or new interpretations of standards, the Contractor will modify examination to conform the most current governing standard in effect at the time of examination.

C.11. MEDICAL EVALUATION/DETERMINATION OF CAUSATION

A. For initial visits, employees should present with the City’s Supervisor’s Report of Injury form 100B to be completed by the physician.

B. The City may supply the contractor with copies of the 100B to keep on site.

C. Contractor will take a detailed history from the employee, review their report of injury, and perform a medical examination. Contractor will provide their best medical opinion on diagnosis and the causal relation to the mechanism of injury as described by the employee and it’s relation/exposure to work at the earliest point in the examination process.

D. If it is the opinion of the Contractor that the diagnosis is most probably not resulting from the mechanism of injury as described by the employee or not work-related, Contractor must notify the City immediately following the determination and forward a transcribed report to the Third Party Administrator within three (3) business days.

C.12. TREATMENT/SERVICES

Contractor will perform and document appropriate medical treatment of all City employees who agree to treat with the Contractor for the work related injury.

A. Contractor will work with the Third Party Administrator to obtain pre-authorization for diagnostic testing beyond plain view x-rays, physical therapy and referrals to specialists.

B. Contractor will not give preference to in-house physical therapy services on referrals for City Employees to receive treatment/services.

C. In some cases, Independent Medical Evaluations may be performed as arranged by the City’s Third Party Administrator, (TPA). At the completion of the IME, the TPA will provide a copy of the report to the Contractor for appropriate management of the case, i.e. additional treatment recommendations, change in work status, case closure, etc. The contractor must contact the designated City representative and the TPA to discuss case management before meeting with the employee, making a determination on the disposition of the case or authoring a work status report to the employee.

BUSINESS SERVICES DEPARTMENT Page 18 of 60

D. Contractor will not use third party referral services for specialists or diagnostics unless approved by the City.

E. The City, from time to time, may request services not specifically outlined in this contract, Request for such services will be at a mutually agreed upon rated and may require a formal amendment.

C.13. WORK STATUS

Contractor will provide a work status report to the employee at the completion of each visit on a form approved by the City.

A. The work status report recommendations will be provided as described in Section I of this scope of work. and will also include the date of the next follow-up appointment, and instructions on when to take narcotic or sedating medications, if prescribed.

B. The City of Tucson supplements compensation for injured City Employees who have accepted workers compensation claims. The Contractor will co-follow to provide a work status on injury cases that have any other status than regular duty/unrestricted work, i.e. off work, modified work, (when restrictions change) and released to regular, unrestricted work. Contractor is to make recommendations on work status based on their expertise in occupational medicine and their best medical opinion of the injured employee’s ability to safely return to work, considering the opinions of the injured worker/s treating physician(s), but not “rubber stamping” those recommendations.

C. Work status of “No-driving” will be provided to City of Tucson Risk Management/Safety. If the employee is a CDL Operator the work status description will clarify if for commercial equipment and vehicles only or all vehicles.

D. The work status report will also be provided to the designated City Group Contract Representative, the employee’s department, and the Third Party Administrator on the same day as the examination, in a method agreed upon by the City and the Contractor.

C.14. WORK STATUS EVALUATIONS

City employees who choose to treat with physicians outside of the Contractor may be required to have periodic work status evaluations by the Contractor. Contractor will conduct these visits the same as ‘Return to Work Examinations. See Return to Work Examinations Section and Work Status Verification Section within this Scope of Work.

BUSINESS SERVICES DEPARTMENT Page 19 of 60

C.15. NO-SHOWS

If an employee does not keep or “no shows” their scheduled appointment, the Contractor must notify the Group Contract Representative and the City’s Third Party Administrator of the missed appointment in a method of notification agreed upon by the City and the Contractor.

C.16. RE-SCHEDULED APPOINTMENTS

Employees on an off-work status or light-duty/restricted work status should not reschedule their follow-up appointments for dates beyond their original follow-up appointment date without approval from the City Group Contract Representative.

C.17. AFTER HOURS TELEPHONE TRIAGE

Contractor will provide after-hours telephone triage service for professional medical advice in emergency situations that occur outside of routine business hours. Recommendations for work status shall not be provided over the phone.

C.18. PHONE CONSULTATIONS

Contractor will provide phone consultations during normal business hours to City employees and Infectious Control Officers, (8:00 am to 5:00 pm Monday – Friday) .

Contractor will provide eligible employees with access to short- term, ongoing, appointment-based sessions with the same clinician via a web or mobile device consultation. These short duration via web or mobile device will be determined by Contractor and City Group Representative.

Clinicians are required to maintain private workspaces to assure HIPPA privacy and freedom from controllable distractions.

C.19. MEDICAL REPORTS

For each employee examined/treated, the Contractor will report the employee’s history, subjective complaints, objective findings, diagnosis, prognosis, and treatment plan.

The signed report will be forwarded to the designated City’s Group Contract Representative and the City’s Third Party administrator within three (3) business days after the examination/visit.

All medical reports for industrial injuries must be typed.

C.20. EXPOSURES PROTOCOL

Contractor shall research, develop and provide exposure protocol information in a format that is readily available to employees who are exposed to HIV, AIDS, Hepatitis or other exposures requiring medical attention. This will include source testing information.

BUSINESS SERVICES DEPARTMENT Page 20 of 60

In addition, Contractor agrees to provide consultative assistance to City employees regarding Hepatitis, HIV and/or TB tests or changes in annual hearing, lung testing and/or Hantavirus.

C.21. GROUP- B: BEHAVIORAL HEALTH SERVICES

The City of Tucson is seeking proposals from qualified and experienced firms or individuals to provide mental health resources in person and via telehealth, including mental health and addiction counseling services for the City of Tucson employees.

Behavioral Health Services - Mental Health Counseling/Psychotherapy

Behavioral Health Services - Mental Health Chemical Dependency Services/Addiction Counseling

A. Requirements

The contractor will adhere to the below requirements:

Attend semi-annual administrative meetings with designated City Staff to address needs/business changes at no additional cost.

Provide invoices to the City of Tucson for payment.

Respond to contact from designated City of Tucson employees verbally or in writing within forty-eight

(48) hours.

Alert the City of Tucson designated staff when fitness for duty examinations are required.

Contracted with the City of Tucson's health insurance plan to allow for additional sessions when recommended.

Behavioral Health Services - Mental Health Counseling/Psychotherapy

The contractor will offer the below mental health counseling/psychotherapy services:

A mental health provider, licensed in the state of Arizona, and qualified to provide psychotherapy/mental health counseling, a certified substance abuse professional, and professional consultation services to City of Tucson employees for work related and personal issues.

Provide all equipment, materials, and personnel necessary to provide services to the City of Tucson employees for job related or personal issues.

Perform professional services and provide general administrative oversight and will maintain confidentiality dictated by industry standards and applicable laws.

Provide other related services and consult with the designated City of Tucson staff as needed or when information is requested.

Participate in professional consulting services to the designated City of Tucson staff as needed on topics including but not limited to expertise, ethical practices, national standards, and employee situations.

Safeguard confidentiality and maintain client confidentiality in accordance with applicable laws.

BUSINESS SERVICES DEPARTMENT Page 21 of 60

Behavioral Health Services - Mental Health Chemical Dependency/Addiction Counseling

The contractor will offer the below chemical dependency/addiction counseling services:

A professional licensed and/or certified practitioner specializing in chemical dependency and addiction counseling services with knowledge of the diagnosis and treatment of alcohol/controlled substance related disorders.

Provide all equipment, materials, and personnel necessary to provide counseling to City of Tucson employees for job related and/or personal issues.

Provide sessions with intent to provide additional sessions if warranted, after available sessions are utilized. When additional sessions exceed contracted agreement for sessions the employee can elect to utilize sessions through their insurance plan or elect to self pay for additional services.

Participate in professional consulting services to the designated City of Tucson staff as needed on topics including but not limited clinical expertise, expert opinions, ethical practice, national standards, best practices and employee situations.

Maintain tact and client confidentiality in accordance with applicable laws.

C.22. Performance Guarantees--All Groups

The below performance guarantees are applicable to all groups. Fees will be assessed Monthly.

Staffing

• Should a City employee on a walk-in basis enter the facility and be turned away or required to return due to lack of staffing to include not having the appropriate medical provider on staff, the Contactor will be assessed a fee equal to Two (2) times what the original full service charge for that visit would have been.

• Should a City employee with a scheduled appointment enter the facility and be turned away or required to return due to lack of staffing to include not having the appropriate medical provider on staff, the Contactor will be assessed a fee equal to Four (4) times what the original full service charge for that visit would have been.

Administrative

• Not receiving required paperwork or clarification/response from the provider within 3 business days when requested for Work Related injury. Assessed Fee will be $250.00.

• Initial email sent to a valid email address or phone call with any City of Tucson request or question not responded to within 48 Hrs. Automated responses are not acceptable. Assessed Fee will be $250.00.

BUSINESS SERVICES DEPARTMENT Page 22 of 60

C.23. Billing

Contractor shall submit invoices for services as follows:

Services for All City Employees:

Invoices for all services other than Industrial Injuries:

City of Tucson: The designated City Group Contract Representative

Attn: Risk Management / The individual department

P.O. Box 27210

Tucson, AZ 85726

Invoices for Industrial Injuries shall be submitted to:

TriStar

PO BOX 2805

Clinton, IA 52733-2805

(note: this information is subject to change – Contractor will be notified of any changes.)

• Invoices to the City shall be monthly for all non-injury care services.

• Contractor must be able to invoice the City by group and by individual departments.

• Under no circumstances will invoices with a first issuance date of over 90 days after services have been rendered be honored.

• Corrected invoices will be the responsibility of the vendor.

BUSINESS SERVICES DEPARTMENT Page 23 of 60

D. OFFER EVALUATION AND CONTRACT AWARD

D.1. PROPOSAL EVALUATION CRITERIA – (listed in relative order of importance)

A. Method of Approach

B. Qualifications & Experience

C. Price Proposal

D.2. INTERVIEWS

The City may interview some or all of the offerors at any point during the evaluation process. If interviews are conducted, information provided during the interview process will be taken into consideration in the evaluation process. The City will not reimburse the Offeror for any costs Offeror incurs during its participation in the interview process.

D.3. ADDITIONAL INVESTIGATIONS

The City may undertake any additional investigations it deems appropriate to evaluate the competence and financial stability of any offeror.

D.4. OTHER INFORMATION

Information that evaluation committee members have about an offeror beyond what is provided in the offeror’s Offer may be taken into consideration during the evaluation process.

D.5. PRICE

A. Tax Offset Policy. If applicable under Section 28-18(6) or Section 28-17(7)(d) of the Tucson Procurement Code, the City will include the amount of all business privilege taxes other than the City’s in evaluating the pricing component of each Offer.

B. Payment Discounts. Any discounts offered by Offeror for payments made within 21 calendar days or more will be deducted from the proposed price in evaluating an offeror’s pricing.

However, the City may take advantage of any early- or timely-payment discounts offered by a vendor. Any proposed payment discount will apply to all purchases and to all payment methods

D.6. CITY’S RIGHT TO WAIVE DEFECTS OR REJECT OFFERS

Notwithstanding any other provision of this solicitation, the City may:

A. Waive any immaterial defect or informality; or

B. Reject any or all submittals, or portions thereof; or

C. Reissue the solicitation.

BUSINESS SERVICES DEPARTMENT Page 24 of 60

D.7. CONTRACT NEGOTIATIONS

At the City’s discretion, it may negotiate with one or more responsible offerors to agree upon the final conditions, terms and price of the Contract. In doing so, the City will treat offerors fairly and will not disclose to any offeror information from responses submitted by other offerors. Exclusive or concurrent negotiations do not constitute a contract award and do not confer any rights to the offerors participating in such negotiations. In the event the City deems that negotiations are not progressing, the City may formally terminate these negotiations and may enter into concurrent or exclusive negotiations with the next most qualified firm(s).

D.8. AWARD OF CONTRACT

A Contract is created when, and only when, it is formally awarded, which occurs when the Business Services Director and the City Attorney sign the Offer and Acceptance page of the Successful Offeror’s submittal. When a Contract is awarded, the City will send the Contractor a Notice of Award.

The City may first issue a Notice of Intent to Award to the Successful Offeror(s). Offeror, if it receives a Notice of Intent to Award from the City, must sign and file with the City, within ten (10) days after receipt of the Notice, all documents necessary for execution of the…