Loading...
HomeMy WebLinkAboutPD04-277 - Amendment - #4 - Valley Medical Center - Corrections Facility Medical Services - 01/01/2012 O Records M ----e me KENT Document WA5HINGTON CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. 3 Vendor Name: Valley Medical Occupational Health Services (OHS) Vendor Number: 34524 JD Edwards Number 1 1 Contract Number: This is assigned by City Clerk's Office Project Name: Corrections Facility Medical Services Amendment Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: 5/ Contract Effective Date: 07/29/04 Termination Date: 12/31/15 Contract Renewal Notice (Days): 30 j Number of days required notice for termination or renewal or amendment i 1 Contract Manager: Jon Straus Department: Police Detail: (i.e. address, location, parcel number, tax id, etc.): Amendment to update staffing levels and hourly rates. Llk rol�gltl ,i s Public\RecordsManagement\Forms\ContractCover\adcc7832 i 11/08 d 5 P KENT WRS4INGT0N FOURTH AMENDMENT TO CORRECTIONS FACILITY MEDICAL SERVICES AGREEMENT THIS FOURTH AMENDMENT TO CORRECTIONS FACILITY MEDICAL SERVICES AGREEMENT is made between the CITY OF KENT, a Washington municipal corporation ("City"), and PUBLIC HOSPITAL DISTRICT NO. 1 OF KING COUNTY (dba Valley Medical Center Occupational Health Services,) a non-profit municipal corporation organized under the laws of the State of Washington ("Vendor"). RECITALS A. On 3uly 29, 2004, the City and Vendor entered into a Corrections Facility Medical Services Agreement for Vendor to provide comprehensive medical services at the Kent Corrections Facility ("Facility"). On November 27, 2006, the parties executed a First Amendment to the Agreement extending the Agreement's term through December 31, 2007, and later by a Second Amendment, extending its term an additional three years, through December 31, 2010. On November 30, 2010, the parties executed a Third Amendment that extended the Agreement through December 31, 2015. B. The parties express their mutual intent and desire to further amend the Agreement to increase staff compensation. NOW THEREFORE, in consideration of the mutual intent, desire and promises of the parties and other good and valuable consideration, City and Vendor agree as follows: 1. Section III, Level of Service and Compensation, Subsection A, Staff - Level of Service and Hourly Rates, is amended to delete that subsection in its entirety and replace it with the following: A. Staff - Level of Service and Hourly Rates. Staffing levels and hourly rates are set forth below. The staffing levels may be altered at the request of the City with thirty (30) days advance written notice to the Vendor and expressed in a written addendum signed by both parties, provided, thirty (30) days advance written notice shall not be required for minor changes mutually agreed upon by the City and Vendor. The Vendor shall provide the following level of service on the days indicated and at the hourly rates indicated: ANNUAL HOURS POSITION 2080 Licensed Practical Nurse ("LPN") @ $41.77/hr 40 Hours per week Work performed Mon-Fri, 7:00 am- 3 .30 pm Total monthly cost: $7,240.13 Total annual cost: $86,881.60 FOURTH AMENDMENT TO CORRECTIONS FACILITY MEDICAL SERVICES AGREEMENT - 1 ANNUAL HOURS POSITION 3120 Registered Nurses ("RNs") @ $70.85/hr 60 Hours per week Work performed Mon-Fri, 12:30 pm- 9:00pm and Sat-Sun, 10:00 am-8:30 pm Total monthly cost: $18,421.00 Total annual cost: $221,052.00 T 72 Medical Doctor, Psychiatrist ("MD") @ $200 00/hr 1 6 Hours per month Work performed as needed Total monthly cost: $1,200.00 Total annual cost: $14,400.00 i 312 Physician's Assistant ("PA") @ $91.52/hr 6 Hours per week Work performed in shifts totaling 6 hours per week at Vendor's discretion Total monthly cost: $2,379.52 Total annual cost: $28,554.24 The total annual expense for Vendor staff at the above levels of service and at the above hourly rates will be $350,887.84. On or around July 1 of each year, Vendor may increase the hourly rates for the LPNs, RNs, PAs under this Agreement if and to the extent it increases the hourly rates for all its LPNs, RNs, PAs pursuant to an applicable labor contract. Vendor will provide City with at least thirty (30) days' advance written notice of such increase and make any such contract available for review by the City, upon request Any such increase will be expressed in a written amendment to this Agreement executed by both parties. B. Estimated Administrative Expenses. The Vendor shall provide the following administrative services* 1. On-call for telephone consultation with LPN, RN, PA, Medical Director, Jail Health Administrator or other doctor; 2. Billing, records management, storage, and scheduling; 3. Medical director oversight; and 4. Administrative oversight. 5. Program support services as called for in Section VI of the Agreement. FOURTH AMENDMENT TO CORRECTIONS FACILITY MEDICAL SERVICES AGREEMENT - 2 6. Provide additional staff coverage during vacations, sick and emergency leaves These administrative services shall be provided at an annual rate of $66,424.80. 5. Except as specifically amended by this Fourth Amendment, all remaining provisions of the Agreement, as well as amendments not superseded by later amendments, will remain in full force and effect. In addition, upon the effective date of this Fourth Amendment, the written provisions and terms of this Fourth Amendment shall supersede all prior verbal statements of any officer or other representative of the City, and such statements shall not be effective or be construed as entering Into or forming a part of or altering in any manner the Agreement or any of Its Amendments. 6. The effective date of this Fourth Amendment is January 1, 2012. By signing below, the parties have executed this Fourth Amendment to the Corrections Facility Medical Services Agreement. CITY OF KENT i By: Petle: t Nam uzette Cooke T lMayjpr Date: o ! a PUBLIC HOSPITAL DISTRICT NO. 1, dba Valley Medical Center Occupational Health j Services By: W� Print Name 1 a r Title: S Cf'�'Z n1 � Date: 1t ( fol lzo- 11 Appr as or th "Ppatr' puty City Attorney P\Qvil\Files\Open Files\1525-Jail Medical Services 2011\FourthAmendment ladMedicalAgreement 2011through2015 docx 7 FOURTH AMENDMENT TO CORRECTIONS FACILITY MEDICAL SERVICES AGREEMENT - 3 I A�® DATE(MM/DO/YYYY) CERTIFICATE OF LIABILITY INSURANCE 10/27/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s) PRODUCER NAMEACT Rosario Day Beecher Carlson - Santa Ana PHONE (714)444-4133 FAX 714)494-4155 A!C No 6 Hutton Centre Drive ao RIES rday@beechercarlson.com Suite 1280 INSURERS AFFORDING COVERAGE NAIC if Santa Ana CA 92707 INSURERAValley Med Valley Self Insured INSURED INSURER B Valley Medical Center INSURER 400 South 43rd Street INSURER INSURER E Renton WA 98055 1 INSURER COVERAGES CERTIFICATE NUMBER.CL11102708201 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VVITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES UNII IS ShOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADOL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE III WVn POLICY NUMBER fMM1DD1YYYYi IMMIDDNYYYI GENERALLIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A X CLAIMS-MADE a OCCUR Valley Medical Center 11/01/2011 11/01/2012 MED EXP(Any one person) $ X _Professional Liability Self Insured program PERSONAL B ADV INJURY $ GENERAL AGGRFG,,TE $ 8,500,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-CCMPIOP AGO $ POLICY PRO LOC COM $ AUTOMOBILE LIABILITY Eac accident) SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accicent) $ „LTOS AUTOS NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS Per acci UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ WC $ WORKERS COMPENSATION OR STATUS OTH- AND EMPLOYERS'LIABILITY ANY PRCPRIETORPARTNER/EXECUTIVE YIN EL EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) EL DISEASE-EA EMPLOYE $ If yes,describe under EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Evidence of Healthcare professional Liability and General Liability Insurance for Valley Medical Center with respects to the Occupational Health Services CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS City of Kent 1230 South Central Avenue AUTHORIZED REPRESENTATIVE Kent, WA 98032 David Harper/ADIETR ACORD 25(2010105) ©1988-2010 ACORD CORPORATION All rights reserved INS025(201005)01 The ACORD name and logo are registered marks of ACORD REQUEST FOR MAYOR'S SIGNATURE KENT Please Fill in All Applicable Boxes { WASHINGTON Routing Information (ALL REQUESTS MUST FIRST BE ROUTED THROUGH THE LAW DEPARTMENT) _ i Originator �,� ', Phone �Oiiginator)• ,S ,Y , Date Sent- r'v �� f i Date Required- 1 t'l;7111 i Return Signed Document to sD 711�O CONTRACT TERMINATION DATE: J3i�U� VENDOR NAME: �l sTYt •� DATE OF COUNCIL APPROVAL:r'G'�/Il- / p r Brief Explanation of Document. L unjc 1` J('wy I All Contracts Must Be Routed Through the Law Department a (This Area to be Completed By the Lain Department) ,.ter x.� s Received: , � Approval of Law Dept.. ECE[VEE'° Law Dept. Comments J OCT ? 3 i �ltb L Date Forwarded to Mayor- ')ffi_, ( , ;:,e Shaded Areas to Be Completed by Administration Staff Received- , Recommendations & Comments: 2 7 2v11 �� Disposition: n7 a Date Returned: 4•t-�v'•'! � r � ) ) i Ia�e S£i,-0 3D5