HomeMy WebLinkAbout01/29/1990 Kevin McDermott, Chair
Patricia DeMond
Ken Peterson
Staff: John Stinson
AGENDA
BUDGET AND FINANCE COMMITTEE
Monday, January 29, 1990
12:00 Noon
City Manager's Conference Room
1. City Physician
2. Contract Procedures
MEMO R A N D U M
January 29, 1990
TO: BUDGET AND FINANCE ~OMMI1-FEE
FROM: JOHN W STI
· NSON, ASSISTANT TO THE CITY MANAGER
SUBJECT: ORDINANCE ADDING FORMAL CONTRACT PROCEDURE FOR
CONTRACTS NOT INVOLVING THE PURCHASE OF GOODS
As a result of a recent review by staff of City practices and procedures
regarding the approval and execution of City contracts, recent changes to the
City Charter and Municipal Code regarding purchasing regulations and recent
experience in litigation, the attached Ordinance is proposed.
The purpose of the Ordinance is to clarify the City's contracting policies and
procedu'res, particularly for those contracts not involving the purchase of goods
(i.e. service contracts).
The Ordinance requires that all contracts not involving'the purchase of goods
be set forth in writing, approved as to form by the. City Attorney, and signed
by the Mayor, a City department head, the Finance Director and filed with the
City Clerk.
Such contracts of $20,000 or more must be authorized by the City Council. This
is consistent with our new ordinance regarding the purchasing of goods.
Contracts not involving the purchase of goods may be amended in writing if signed
by all original signatories.
Such contracts which required City Council authorization {$20,000 or over} except
public works contracts, must be amended by Council action.
For public works contracts not involving the purchase of goods, amendments must
be by Council action unless each individual change order does not exceed $10,000
and the cumulative amount of change orders for that contract do not exceed 25%
of the original contract amount.
JWS.alb
Attachment
cc: Honorable Mayor and City Councilmembers
J. Dale Hawley, City Manager
FORMAL CONTRACT PROCEEOURE - CONTRACTS NOT INVOLVING THE PURCHASE OF GOODS
CITY OF BAKERSFIELD
FOLLOW GUIOELINES
FOR PURCHASING OF
GOODS
NEEDS CITY COUNCIL
OOES THE CONTRACT . AUTHORIZATION RNO
! . INVOLVE THE REOUIREO
pURCHRSE OF GO00S? SIGNATURES* '
~ / NO
FN OOES OROER
tHRNGE
· FOLLOVI PROCEEOURE EEOS CITY COUNCIL EXCEEO $10,000 OR
FOR CONTRACTS NOT I' AUTHORIZATION ANO DOES CUMULATIVE
INVOLVING PURCHASE ! REOUIREO AMOUNT EXCEEO ~5%
OF GO00S / SIGNATURES* OF ORIGINAL
CONTRACT AMOUNT?
~' · '~ / NO
IS THE CONTRACT IS IT R PUBLIC NEEDS REOUIREO
· AMOUNT $~0,000 OR RMENOI ENT )/OAKS CONTRACT? SIGNATURES*
MORE?
I EEDS CITY COUNCIL
NEEDS REOUIRED m RUTHORIZRTION AND
SIGNATURES* ! REOUIRED
,SIGNRTURES*
DRAFT
ORDINANCE NO. NEW SERIES
AN ORDINANCE OF THE COUNCIL OF THE CITY OF
BAKERSFIELD 'ADDING SECTION 3 20 105 TO THE
BAKERSFIELD MUNICIPAL CODE RELATING TO
FORMAL COI~CT PROCEDURE FOR CON~CTS NO~
II~OLVING ~ PURCI'~SE OF GOODS.
BE IT ORDAINED by the Council of the City of
Bakersfield as follows-
SECTION 1.
Section 3.20.105 is hereby added to the Bakersfieid
Municipal Code to read as follows:
3.20.105 Formal contract procedure - Contracts not involving
the purchase of goods.
' A. All contracts not involving the purchase of goods shal1
be set forth in writing approved as to form by the City Attorney,
signed by the Mayor, a City department head, the Finance Director
and filed with the .City Clerk.
B. Ail such contracts under which the City is obligated to
pay $20,000.00 or more, whether or not such amounts will'Be paid.
or reimbursed by a third party, shall be authorized only by the
City Council. Such contracts shall also require the signatures
set forth in subsection A. of this section.
C. Amendments.
1 No contract subject to the provisions of this
section may be amended or otherwise modified unless the terms of
such amendment are set forth in writing and signed on behalf of
'eaCh party. ~No contract requiring City Council authorization,
except for public works contracts, may Be amended, except By
council action.
2. Each.amendment to a public works contract~ (change
order) not exceeding an amount of $10,000.00 and which, together
with all other previously approved change orders for that
contract, does not exceed twenty-five percent (25%) of ~the
original contract amount, need not be authorized by the City
~Council but shall require the signatures set forth in subsection
A. of this section, regardless of whether the City's obligation
under the original contract was for $20,000.00 or more. All
other change orders shall be authorized only by the City Council.
D. The City of Bakersfield shall not be bound by any
representation of any officer,.employee or agent of the City
which would serve to create or-amend a contract unless and until
such representation has been set forth in writing and approved
and signed as set forth in this section.
SECTION 2.
This ordinance shall be posted in accordance with the
City Charter provisions and shall become effective thirty (30)
days from and after the date of its passage.
o0o
- 2 -
I HEREBY CERTIFY that the foregoing Ordinance was
passed and adopted by the Council of the City of Bakersfield at a
regular meeting thereof held on , by the
following vote: .~
CITY CLERK and Ex Officio Clerk of the
Council of the City of.Bakersfield
APPROVED
CLARENCE E. MEDDERS
MAYOR of the City of Bakersfield
APPROVED as to form:
ARTHUR J. SAALFIELD
CITY ATTORNEY of the City of Bakersfield
LCM/meg
CONTRACT.1
1/29/90
- 3 -
MEMORANDUM
January 29, 1990
TO: BUDGET AND FINANCE COMMITTEE
Councilmember Kevin McDermott, Chair
Councilmember Patricia DeMond
Councilmember Ken Peterson
FROM: J. DALE HAWLEY, CITY MANAGER ~
· SUBJECT: CITY PHYSICIAN CONTRACT
As I indicated in my report to the City Council on January 8, 1990, it is
my recommendation that, during August or September, the City request
proposals from physicians who would perform pre-employment, fitness and
industrial injury services.
Upon receipt of the proposals, we should obtain the assistance of an
expert in the field of industrial medicine to review the information
submitted, inspect the facilities and evaluate the qualifications of the
physicians and staff.
Due to the projects currently underway in the Personnel Division, I
recommend that we postpone the City Physician evaluation until August or
September of this year.
I agree with the three suggestions that were presented to the Council on
January 24th by Valley Industrial Medical Group.
JDH.alb
Attachments
cc: Honorable Mayor and City Councilmembers
MEMORANDUM
January 26, 1990
TO: BUDGET & FINANCE COMMITTEE
FROM: SUE WHITFIELD, PERSONNEL MANAGER
SUBJECT: CITY PHYSICIAN CONTRACT
BACKGROUND
The City of Bakersfield signed an agreement with San Joaquin
Industrial Medicine Associates in February 1987. Dr. Willard B.
Christiansen is the facility's Medical Director. The Agreement
between the City and San Joaquin Industrial Medicine Associates
is automatically renewable on February 1st of each year, with a
60-day termination clause by either party.
The services provided by the City's physician include:
Pre-employment physicals
Drug screening
Fitness for Duty physicals
Driver's License physicals
Hepatitis B Inoculations for Fire Fighters
Worker's Compensation Treatment
Serves as Expert Medical Witness for Attorney's Office
and the three Civil Service Boards regarding Medical Appeals
For'the calendar year January 1, 1989 through December 31, 1989
the City paid San Joaquin Industrial Medicine Associates $71,233
for pre-employment physicals, drug screenings, fitness-for-duty
physicals, driver's license physicals, and Hepatitis B
inoculations;~ $46,515 for workers' compensation treatment; and
$10,675 in fees for the City physician's costs in regard to
liability claims; for an approximate total of $128,423. The
· Division of Industrial Accidents reviews and adjusts the City
Physician's bills for the treatment of injuries relating to
Workers' Compensation. Exhibit A is a chart showing the City's
Workers' Compensation injuries for the past five fiscal years.
Other bills are paid based upon a fee schedule approved in the
City's contract with San Joaquin Industrial Medicine Associates.
(Exhibit B is the contract and fee schedule)
Most lab work and tests are completed locally. The exception is
Drug Testing. The Federal Government has designated that those
laboratories which are certified by the National Institute of
Drug Abuse (NIDA) are the laboratories that meet the standards by
which drug testing should be completed. There are only 6 NIDA
Certified Laboratories in California at this time. None are
located in Bakersfield. Laboratory Specialists, Inc., the
laboratory used by Dr. 'Christiansen, is NIDA certified.
Budget & Finance Committee
January 26, 1990
Page 2
CONSIDERATIONS
The City Physician gets involved in a myriad of services.
The total services are a great deal more than pre-employment
physicals, or assessment and treatment of on the job injuries.
Regarding a new City Physician, these are some of the areas the
Council may want to consider:
1) Some medical facilities use Physicians Assistants rather
than medical doctors. Exhibit C lists the medical doctors and
Exhibit D lists the professional and administrative staff provided
under the current contract with the City Physician.
2) The City needs a physician who is able to write
comprehensive, logical and concise reports. In this regard, the
Attorney's Office regularly requests reports from the City
Physician to be used in litigation issues. In addition, the City
Physician's reports are also used for the three Civil Service
Boards for review whenever a medical appeal is heard.
3) Due to the nature of the work schedule of City employees,
emergencies may arise at any time, which require the assistance of
a physician. The current City Physician receives calls on a
24-hour basis. ' He refers after hour routine calls to the
emergency room, and personally responds to all cases of an
emergency nature.
4) The type of medical issues that exist in a city the size
of Bakersfield are varied. They may include toxic and pesticide
exposures, disability evaluation, industrial and occupational
injuries, and drug testing. To address the needs of City
employees, it is necessary that the City Physician have a
background in these areas.
5) The City Physician should have good interpersonal skills
and have the ability to relate well with department heads and
management.
6) Finally, the accessibility of the physician to City Staff
is important. On a regular basis, Management Staff may consult
with the City Physician regarding such medical issues, as light
duty assignments, work restrictions, or medical problems that may
impact the employee's ability to perform the job.
Budget & Finance Committee
January 26, 1990
Page 3
STATUS
At this point, three medical facilities have verbally expressed
an interest in providing services to the City. They are:
Bakersfield Family Medical Center
Dr. Michael Davies
Medical Director
4580 California Avenue, Suite 100
Bakersfield, CA 93309
(805) 327-4411
Medi-Center of Bakersfield, Inc.
Mr. Steve Laird
Director of Marketing/Industrial Relations
820 - 34th Street
Bakersfield, CA 9330'1
(805) 325-6334
Valley Industrial Medical Group
Dr. Larry M. Cho
Medical Director
2501 "G" Street
Bakersfield, CA 93301
(805) 327-2225
The representatives from each facility mentioned above, as well as
the current City Physician, are available to meet with the Budget
& Finance Committee, if the Committee desires.
RECOMMENDATION
At this time we would prefer not to change the City Physician.
It appears our employees are satisfied with the medical services
offered by Dr. Christiansen. In addition, the cost to the City
has remained the same as outlined in the fee schedule agreed to
in 1987.
Currently, a number of projects are being handled simultaneously.
We are reviewing the health care issue, and will be selecting a
medical consultant to work with staff; we are in the process of
reviewing pre-paid dental proposals; we are preparing information
for the budget; and negotiations with the Police Unit have just
started.
Our plan is in August or September 1990 to have a medical doctor,
with an expertise in industrial medicine, evaluate proposals from
interested providers and make a recommendation to staff. It
should be noted that it will take approximately three months to
conduct a comprehensive review and evaluation of medical
facilities.
4:CPC
cc: J. Dale Hawley, City Manager
EXHIBIT A
WORKERS' COMPENSATION INJURIES
FISCAL YEARS: 1988-89 through 1984-85
FISCAL YEAR 1988-89 1987-88 1986-87 1985-86 1984-85
WORKERS'
COMPENSATION
CLAIMS 216 201 196 195 206
LOST DAYS 887 1,522 1,855 1,033 1,912
TOTAL PAID $854,127 $828,062 $797,145 $733,411 $736,404
4:WCI
AGREEMENT NO. 87-9
CONTRACT FOR PROFESSIONAL SERVICES
THIS AGREEMENT, made this 14th day of January
198 7, between the CITY OF BAKERSFIELD, a municipal corporation
(CITY), and San Joaquin Industrial Medicine Associates, an
association of physician related services operating under the laws
~of the State of California, (SJIMA).
RECITALS
WHEREAS, the City of Bakersfield desires pre-employment
physicals for employees, fitness for duty physicals, and workers
compensation treatment as well as other miscellaneous medical and
risk management services; and,
WHEREAS, SJIMA is a group of physicians and staff
personnel experienced in providing physical examinations and
other related work to employers; and,
WHEREAS, SJIMA . has submitted a fee schedule for the type
of work desired by the City;
THEREFORE, City and SJIMA mutually agree as follows:
.AGREEMENT
1. SCOPE OF WORK: SJIMA agrees to provide, and the
City agrees to utilize, the services of the physicians and staff
of SJI~A to perform pre-employment physicals, fitness for duty
physicals, workers compensation treatment, and other medical
work as agreed in writing between the parties and according to the
attached fee schedule, Exhibit "A", and the attached occupational
groupings, Exhibits. "B", "C.", "D", "E", "F", and "G" except
workers compensation. A list of SJI~A physicians and staff is
attached as Exhibit "H". Changes to staff or physicians listed
in Exhibit "H" shall be forwarded to the City within 30 days.
SJIMA agrees to provide the listed services to the City on a
priority basis for City employees-and management.
2. COMPENSATION: Compensation to SJIMA for services
'rendered under this contract shall consist of payment of the fees
as set forth in Exhibit "A" hereto except workers compensation.
3. PAYMENT: SJIMA shall sUbmit detailed invoices for
services provided to City for City review and approval. SJIMA
shall be paid by the City for services rendered after submission
and approval of said invoices within 45 days.
--1--
4. TERM: This agreement shall continue for a period
of one year commencing February 1, 1987, and shall automatically
renew on an annual basis unless otherwise terminated. Either
party may terminate this agreement upon 60 days written notice.
5. CHOICE OF HOSPITAL: Bakersfield Memorial Hospital
will be used by the parties to this agreement whenever reasonably
possible. The emergency room services at Bakersfield Memorial
Hospital shall be used exclusively for emergency treatment under
this agreement unless the use of said facility would endanger or
otherwise result in reasonably foreseeable harm to the one receiv-
ing said emergency services.
6. WAIVER OF DEFAULT: The failure of any party to
enforce against another a provision of this Agreement shall not
constitute a waiver of that party's right to enforce such a provi-
sion at a later time, and shall not serve to vary the terms of
this Agreement.
7. FORUM: Any lawsuit pertaining to any matter arising
under or growing out of this contract shall be instituted in Kern
County, California.
8. TIME: Time is of-the essence in this Agreement-
9. HEADINGS: All paragraph or section captions are
for reference ~nly, and shall not be considered in construing this
Agreement.
10. NOTICES: All notices relative to this Agreement
shall be given in writing and shall be sent by certified or
registered mail and be effective upon depositing in the United
States mail'. The parties shall be addressed as follows, or at
any other address designated by notice:
CITY OF BAKERSFIELD
City Hall
1501 Truxtun Avenue
Bakersfield, California 93301
San Joaquin Industrial Medicine Associates
2100 "~" Street
Suite 240
Bakersfield, California' 93301
11. ASSIGNMENT: This contract shall not be assigned by
any party, or any party substituted, without prior written consent
of all the parties.
-2-
12. 'BINDING EFFECT: The rights and obligations of this
Agreement shall inure to the benefit of,-and be binding upon, the
parties to the contract and their heirs, 'administrators, execu-
tors, personal representatives, successors and assigns.
13. ATTORNEY'S FEES: In any action to enforce the terms
of this Agreement, the prevailing party shall be entitled to
recover its attorney's fees and court costs and other nonreimbur-
sable litigation expenses, such as expert witness fees and inves-
tigation expenses.
14. MERGER AND MODIFICATION: This contract sets forth
the entire agreement between the parties, and supersedes all other
oral or written provisions. This contract may be modified or ter-
minated 0nly in a writing signed by all the parties.
15. COMPLIANCE WITH ALL LAWS: SJIMA shall, at SJIMA's
sole cost, comply with all of the requirements of Municipal,
State, and Federal authorities now in force, or which may. hereaf-
ter be in force, pertaining to this Agreement, and shall faith-
fully observe in all activities 'relating to or growing out of this
Agreement all Municipal ordinances and State and Federal statutes,
rules or regulations now in force or which may hereafter be in
force.
16. INDEPENDENT CONTRACTOR: This Agreement calls for
the performance of the services of SJIMA as an independent
contractor, and SJIMA. and its staff will not ~be considered
employees of the City for any purposes and are not entitled to any
of the benefits provided by City to its employees. This Agreement
shall not be construed as forming a partnership or any other asso-
ciation with SJIMA other than that of an independent
contractor.
17.~ INSURANCE: During the term of this Agreement,
SJIMA administrative staff shall maintain a single limit compre-
hensive general liability insurance policy in an amount of not
less than $1,000,000 per occurrence with combined liability for'
personal injury and property damage with a reliable insurance car-
rier authorized to do business in the State of California. Said
policy or policies of insurance shall expressly name the City and
its agents, officers, and employees as additional insureds. Said
insurance shall not be subject to cancellation, non-renewal, or
coverage reduCtion without ten (10) days written notice to City.
SJIMA shall provide to the City proof of insurance endorsements
and certificates of insurance p~ior to execution of this
Agreement. Said proof of endorsements and certificates of insur-
ance shall be attached to this Agreement as Exhibit "I". Each
named physician in Exhibit "H" shall carry medical malpractice
insurance.
IN WITNESS WHEREOF, the parties hereto have caused this
Agreement to be executed by the day and year first above written.
CITY O~ BAKERSFIELD
Mayor
APPROVED AS TO FORM:
~7 ~C~ty Attorney nance
COUNTERS IGNED:
San Joaquin Industrial Medicine Associates,
Medical Director
-4-
A.PROSER
CONTRACT FOR PROFESSIONAL SERVICES
(SJIMA)
San Joaquin Industrial Medicine Associates
Administrative Offices
2100 "F" Street, Suite 240
Bakersfield, CA 93301
B05 324-8811
PHYSICAL EXAMINATION - FEE SCHEDULE
COMPLETE HISTORY & PHYSICAL EXAMINATION. $25.00
EKG $25.00
AUDIOGRAM (hearing test) $15.00
PU~LMONAR~ FUNCTION TEST $15.00
URINE PREGNANCY TEST $15.00
* SERUM PREGNANCY TEST $21.50
* SERUM LEAD LEVEL $20.00
* CHOLINESTERASE LEVEL $30.00
* CBC WITH D!FFERENT!~.L $10.00
* BLOOD LIPID PROFILE $20.00
* RPR (VDRL) $12.00
* CHEM-ZY.ME PANEL (2~.) $!2.00
* CHEM+CBC+RPR $18.00
* CHEM+CBC WiTH
........... ""~ $!5.00
* BLOOD GLUCOSE SR.00
UA
$5.00
TB SKiN TEST $5.00
):- RAY S
CHEST - PA (single view) $20.00
PA & LATERAL $30.00
BACK - Lumbosacral Spine (2 views) $40.00
(3 views) $50.00
(4 views) $60.00
COF~OLETE LUF~BOSACP~.L SPINE (5 views) $75.00
uRINE DRUG SCP~EN
: $30.00
DEPARTMENT OF m ~c~ ~ -
.RA! ._ OR~.T~ON (DRIVER) PHYSiCDJ5 EX~-M $25.00
CARDIAC ST-~SS TEST $200.00
CERTAIN FITNESS FOR DUTY' SERVICES M~AY REQUIRE ADDITIONAL FEES.
* Ail serum lab work includes drawing fee
** Fees quoted are based on providing all occupational health
services.
~kHIB.T
San doatluin industrial Medicine Associates .-
AOrninistr~*We
21 O0 "F" Stree~ Suite 240
Bakersfield; CA 93301'
8O5 324-8811
p~e-employment physlcsl gx~mln~tlon Aegui~ements
Group A (Heavy Labor)
Complete History and Physical Examination
CBC ~:ith Differential
Chemzyme Panel
UA¸
UB Skin
Five (5))i-ray ¥ie~?s cf the Lu~osacr~! Spine
Pulmonary Punction Tes~
Audiogram
EKG (if ~0 ~,emrs cf age or over, cr at physic~mn's
Urine Drug Screen
-* See Below
** and a6ditiona! tests as a~prcprlate - at physician's
6iscretion ..
EXHIBIT "C"
ADminisTrative Offices
21 OD "F" Street. Suite 240
Bakersfield, CA °~3301
805 324-8811
CI~v OF BAk~RS:--~D
Pre-employment 'Physical Examination Requirements
GROUP B (Moderate Labor)
Complete History and Physical Examination
with ~:=ferentia!
Chemzy~e P~.ne!
UA
TB Skin
· '~ee (3) X-ray ¥iews cf the Lmv~csacra! c-~,~ (.,ay be
increased zo 5 v~,e%:s at zhe discreuion or the
Pu!mc. nzry Functicn Test - if =rr_cpriate for job c!assificauion
Audio~r~m - if appropriate fcr job c!assificaticn *
EEG (at physician's discretion)
Urine Drug Screen
** See Below
* See attacD~nt
** and additional tests as appropriate - at ~hvsiclan's
discretion
C~'"v_~. OF BAKERSFIELD
Pre-employment Pbysicat Examination Requirements
GROUP C (Light Work)
Commlete History and o'~,,~-ical Examination
CBC with Differential
Chemz3~e Panel
UA
TB Skin ~'=:
EKG (if 40 years cf =~ -_, _
. -9- or or=- or at =hvslcian's discretion)
Urine Drug Screen
** See Below
** and additional tests as aoorcoriate - at '~,~'~c-',an's
discretion
J Aoministrative Offices
21 DO "F" Stree% Suite 240
Bakersfield,. CA 9.3301
805 32~-8811
C~_TY OF BAKERSF!EL_D
Pre-employment Physical Examination Requirements
SEASONAL WORKERS
Ccmp!e~e History =n~ Pbv£ica~
UA °
5~o (2))i-ray \Tiews cf the L''~,~osacrmi S.~ine - ~-' mp?roprir-te
for jo5 classification .~
Urine Drug Screen
** See Below
and ~_d~iticna! Costs ms appropriate - mt physician's
discreet-on
~ .. EXHIBIT "F"
Administrative
210O"F" Street, Sui~e2,~O
Bakersfield~, CA 93301
805 32z,-8811
CITY OF BAKERSFIELD
Pre-employment Physical Examination Requirements
GROUP C (Department Heads)
Complete History and Pbysizal Examination
CBC ~:ith Differential
Diood Lipi'
UA
(2) X.-rsy ¥ie'~..'.s cf Chest
Cardiac Stress Test (at discretion of ex~,,ining '~,~ lan) :
Urine. Drug Screen
** See Below
** and ad~itiona! tests as appropriate - at phI'sician's
discreticn
EXEZBIT "G .... .
S~n Joaquin Industrial Medicine Associates
A~mmis~rative O,'N roes
2100 "F" Street. Suite
Bakersfield,' CA, 93301 .'
805 32,4-8811
Pre-employment Physical Examination Requirements
PUBLZC SAFETY OFFICERS (Fire and Po!_~e)
Comp!e%e History and ?hysical Examination
Chemzyme Panel
UA
~%~mcnarv ?%notion
Audio~r~m
(2) Y-r-ly Vie-~:.s c'-~ Chest (?A and
Five (5) X-ra',¢ Views cf t'.'.-
Car,!a: Stress
Urine Drug Screen . ' .... ' :' "
~'~' See Below
and additicna! tests as -~.r ~ri-t- - . _ -
discretion
· EXHIBIT C
SAN JOAQUIN MEDICINE ASSOCIATES PHYSICIANS
Willard B. Christiansen, M.D. Robert C. Marshall, M.D.
INDUSTRIAL MEDICINE EAR-NOSE-THROAT
DISABILITY EVALUATION 2203 - 19th Street
2021 - 22nd Street Bakersfield, CA 93301
Bakersfield, CA 93301 (805) 327-0657
(805) 327-9617
Martin Bragg, Ph.D Charles Fritch, M.D.
Josh Haskett, Ph.D OPHTHALMOLOGY
PSYCHOLOGY 2525 Eye Street
3600 San Dimas Street Bakersfield, CA 93301
Bakersfield, CA 93301 (805) ~327-8511
(805) 327-7621
David J. Elbaum, M.D. 'Gregory Olson, M.D.
DERMATOLOGY OPHTHALMOLOGY
2323 - 16th Street, Suite 204 2920 'F' Street, Suite B-1
Bakersfield, CA 93301 Bakersfield, CA 93301
(805) 322-5333 (805) 327-0843
Michael MacDuff, M.D. CENTRAL CARDIOLOGY
DERMATOLOGY CARDIOLOGY
2215 'G' Street 2110 Truxtun Avenue
Bakersfield, CA 93301 Bakersfield, CA 93301
(805) 324-1312 (805) 323-8384
Richard M. Deaner, M.D. Johnson Jung, M.D.
Richard O'Reilly, M.D. INTERNAL MEDICINE
CHEST & CARDIO-VASCULAR SURGERY 3551 'Q' Street
2323 - 16th Street, Suite 302 Bakersfield, CA 93301
Bakersfield, CA 93301 (805) 327-9534
(805) 325-4257
Dale T. Herriott, M.D. Arvind S. Shah, M.D.
PULMONARY DISEASES U.R. Varanasi, M.D.
2525 Eye Street, Suite 2B INTERNAL MEDICINE/NEPHROLOGY
Bakersfield, CA 93301 620 - 34th Street
(805) 325-7797 Bakersfield, CA 93301
(805) 324-4721
Stephen J. Helvie, M.D. Thomas H. Stewart , D.D.S.
NEUROLOGY GENERAL DENTISTRY
2323 - 16th Street, Suite 506 3809 San Dimas Street, Suite B
Bakersfield, CA 93301 Bakersfield, CA 93301
(805) 322-1770 (805) 327-3971
John W. Lucas, D.D.S. Albert R. Swafford, M.D.
ORAL SURGERY ORTHOPEDIC SURGERY
ORAL MAXILLOFACIAL SURGERY SURGERY OF THE HAND
1600 'F' Street 1800 Westwind Drive, Suite 201
Bakersfield, CA 93301 Bakersfield, CA 93301
(805) 327-2051 (805) 325-5111
Loarn D. Robertson, Ph.D. Michael C. Tivnon, M.D.
KINESIOLOGY/ERGONOMICS ORTHOPEDIC SURGERY
FUNCTIONAL CAPACITY EVALUATION 3900 San Dimas Street
1800 Westwind Drive, Suite 101 Bakersfield,~ CA 93301
Bakersfield, CA 93301 (805) 327-0843
(805) 327-0382
EXHIBIT D
SAN JOAQUIN INDUSTRIAL MEDICINE ASSOCIATES
Professional and Administrative Staff
Carol Hewes, Director
San Joaquin Industrial Medicine Associates
Peggy Bainbridge, R.N., B.S.N., Occupational Health Nurse
San Joaquin Industrial Medicine Associates
Linda Goad, Administrative Assistant
San Joaquin Industrial Medicine Associates
Loarn Robertson, Ph.D., Clinical Director
California Work Diagnostic & Rehabilitation center
Linda. Bailey, O.T'
California Work Diagnostic & Rehabilitation Center
Christine Mullinax, M.S., ACSM Certified
Calif°rnla Work Diagnostic & Rehabilitation Center
Karan Brown, C.O.T.A.
California Work Diagnostic & Rehabilitation Center
Derek Thompson, R.P.T., Director of Physical Therapy
California Physical Medicine
Mark Kurtz, R.P.T.
California Physical Medicine
Kristi McDonnel, R.P.T.
CalifornIa Physical Medicine
Reid Jackman, R.P.T.
California Physical Medicine
San Joaquin Industrial Medicine Associates contracts with safety
and claims consultants (up to 120 hours per year) for safety,
claims and risk management services.
INDUSTRIAL
GOOD EVENING HONORABLE MAYOR-AND COUNCILMEMBERS
I am Dr. Larry tho, Medical Director of Valley Industrial
Medical. Group. I am here this evening along with some of
my colleagues from Bakersfield Occupational Medical. Group
and Medi Center.
We came this evening with the intention of hearing the report
and comments from the Budget and Finance Committee to the
City Council regarding the motion to send out to bid the City
of Bakersfields' industrial medicine contract. The City's
current contract is automatically renewed February first of
each year. This afternoon, however, I was informed that
this business matter was not placed on tonight's agenda
because the Budget and Finance Committee will be meeting on
Monday, January 29, 1990.
Our concern at this time is, since there is an automatic
renewal clause in the existing contract, will the current
contract be renewed if the Budget and Finance Committee
cannot reach a decision on this matter by February 1, 1990.
When we left these chambers two weeks, we felt that the
contrary would happen based upon the council's motion.
Those of us here this evening have some comments that 'you
might find'helpful:
1. That your Budget and Finance Committee ask the assis-
tance of experts in the field of industrial medicine and risk
management to assist you in your deliberations such as
insurance agents or brokers that deal exclusively in workers'
compensation and/or employers with'a payroll close to the
size of the City's who are either self insured or privately
insured.
2. We believe it is important when reveiwing your
workers' compensation package that you should not comingle
that evaluation with that of private health care for your
employee package. While they are both medical in nature, it
is like mixing apples anti oranges.
3. You may also want to consider having some input from
a member representing your employees in choosing your
industrial medical care provider. As I am sure you are
aware, traditionally, unhappy employees cDst the employer,
the taxpayer in this case, a great deal more than a happy and
content employee.
We.believe that we all have the same goal in mind and that is
to .be as cost effective as possible yet provide the best
2501 "G" Street · Bakersfield, CA 93301 · (805) 327~2225
medical care possible to 'our dedicated City employees.
We strand ready to work with you to achieve that goal in the
qui. ckest possible time frame.
Respectfully,
Va].ley Industrial Medical Group
Bakersfield Occupational Medical Group
Medi Center
MEMORANDUM
JANUARY 16, 1990
TO: DALE HAWLEY, CITY MANAGER
FROM: JERRY WEBER, CLAIMS ADMINISTRATOR ~ ~.
SUBJECT: "CITY PHYSICIAN"
Greg Klimko asked me to write a memo to you regarding the selection of
Dr. W.'B. Christiansen as the "City Physician."
In 1986, management's dissatiSfaction had gradually grown regarding the
City Physician, Dr. M.C. Barnard, and his Niles Medical and Surgical
Group regarding 1) pre-employment physicals; 2) fitness for duty
physical; and 3) the treatment of our industrially injured employees.
As these types of examinations and treatment were being paid for by
Personnel and the Self-Insurance Program, Ken Pulskamp asked Margaret
Ursin and myself to put together a bid proposal package. We put the
proposal together along with comments and suggestions solicited from
Ken Pulskamp, Richard Oberholzer, and Bruce Codding, a Risk Management
Consultant who was working with the City at the time.
A request for proposal letter was sent to ten medical groups and four
hospitals on August 19, 1986.
The proposals were reviewed and on-site inspections and interviews of
some of the physicians were conducted by various department.heads,
Margaret, and myself. There were a number of.meetings with department
heads to discuss the proposals and who could best serve the City's
needs.
A decision was made to use San Joaquin Industrial Medicine Associates.
Meetings were held with their staff regarding procedure and they
reviewed all job descriptions and gave suggestions for the types and
extent of pre-employment examinations. A contract for professional
services was entered into with San Joaquin Industrial Medicine
Associates effective February 1, 1987, for pre-employment physicals,
fitness for duty physicals, and workers' compensation treatment.
San Joaquin Industrial Medicine Associates consists of Dr. Christiansen
as the Medical Director, support staff personnel, and a number of local
medical specialists.
Attached for your review is a copy of the bid letter, a list of who the
bid proposals were sent to, the proposal, and the Contract.
cc: Greg Klimko
MEMORANDUM
January 8, 1990
TO: HONORABLE MAYOR AND CITY COUNCILMEMBERS
FROM: J. DALE HAWLEY, CITY MANAGER ~
SUBJECT' EVALUATION OF PROFESSIONAL MEDICAL SERVICES
AND MEDICAL PROGRAMS
In view of the escalating health care costs, one of the long-range plans
includes an evaluation of the various medical programs currently being
utilized by the City.
We are currentlyin the process of evaluating proposals for o~r "pre-paid"'
dental services. Proposals have been received from three dental
facilities. The next step in the evaluation process is to have a dentist,
who is also a consultant, review the proposals~ visit the facilities, and
comment upon-same..
In addition, plans are also being formulated regarding going"out-to-bid"
for our Health Net and Fee-For-Service plans for the 1991 year.
As part of the City's re-evaluation of their total medical programs, I
also.intend.to have a cOnsultant evaluate proposals from physicians who
are.interested..in providing their services as "City Physician."
Since this process would, take approximately three to four months to
complete, it would commence sometime in August/September of this year.
The re-evaluation would be one more facet of the ongoing program to review
the City's medical programs in order to contain health care costs.
JDH. al b
C I T Y O F
OFFICE OF CITY MANAGER
January 2, 1990
Dr. Larry M. Cho,
Valley Industrial Medical 6roup
2501 "G" Street
Bakersfie]d, CA 93301
Dear Dr. Cho:
Your letter of November 30, 1989 to Councilmember Peterson was referred
to me for response.
On November ZO, 1989, your Administrative Director, Stephanie Cho, called
me and' asked the terms of the City's contract with Dr. Christiansen. I
was not familiar with the details of the agreement, therefore, I
transferred her call to Sue Nhitfield, the City's Personnel Manager.
I would like to give you some background on our present contract with Dr.
Christiansen. For sixteen years, prior to 1987, the City's physician was
Dr. Barnard. Due to various reasons, the City decided to seek proposals
fora new contract. Several proposals were submitted, including one from
your firm. TheSe proposals were reviewed by a Committee which included
the City Attorney, Fire Chief,.Insurance Coordinator, and the Assistant
City Manager. The Committee recommended Dr. Christiansen with San Joaquin
Industrial Medicine Associates for the following reasons:
1. Dr. Christiansen had been involved with the treatment
industrial injuries for over twenty years and had lectured
extensively throughout California on the treatment of industrial
injuries and disability evaluation.
Z. He had extensive experience in the treabnent of toxic and
pesticide exposures, as well as drug testing.
3. He was on-call twenty-four hours a day.
4...All his treatmbnt was provided by medical doctors and all physical
examinations are performed by licensed M.D.'s.
5. .His bills for treabnent of injuries were to be reviewed and
.adjusted to the amount recommended by the Division of Industrial
Accidents.
6. He provided a complete range of services, such as physical therapy
and functioning capacity evaluations.
'150'1TRUXTUN AVENUE · BAKERSFIELD, CALIFORNIA 93301 · (805) 326-3751
Dr. Larry M. Cho, M.D.
Valley Industrial~Medical Group
January 2, 1990
Page -Z-
7. He had extensive experience in medical,legal litigation, and has
testified in many areas, including orthopedics, neurology, toxic
and pesticide exposures and drug abuse.
8. Others who were contacted spoke highly of Dr. Christiansen.
Dr. Christiansen provides for more services than only performing physical
examinations and treating industrial injuries. He has been used by the
Cityto evaluate not only personal injury cases, but also cases of alleged
police brutality. The City has not lost any of the cases in which he has
been involved. He has saved the City considerable amounts of money, not
only in medical care, but in the area of personal injury litigation, as
well as providing many services at no charge.
The terms of the contract with San Joaquin Industrial Medicine Associates
states that the "agreement shall continue for a period of one year,
commencing February 1, 1987, and shall automatically renew on an annual
basis unless otherwise terminated."
Since it was time for the annual review of our Medical Provider Contract,
I discussed this issue with' the Department Heads and they all recommend
no change in our'provider at this time. It was their opinion that Dr.
Christiansen has done excellent service for the City~
Regarding your request for itemized statements and other cost information,
it will take about 135 hours to gather the information together. The
information covers a wide range of services and involves several City
departments. Most of the files are in storage. It you want us to
proceed, please let me know. We will estimate the cost of preparing the
data. At the time you are notified of the cost, a deposit of one-half the
estilmated cost of preparing the information Hill be required.
If I can be of further assistance, please contact me at 326-3751.
Sincerely,
City Manager y ~
JDH.alb
cc: Honorable Mayor and City Councilmembers
VALLEY
INDUSTRIAL
MEDICAL
anou
30,
Kenneth Peterson
6501 Bridgeport Lane
Bakersfield, CA 93309
Dear Mr. Peterson:
Thank you for taking time out of your busy schedule to speak
with Jimmy Shiu, our Industrial Relations Director regarding
our industrial medical service and the possibility of
providing this service to the City of Bakersfield.
Valley Industrial Medical Group was started over five years
ago in Bakersfield, CA to offer expert top qua].ity med~.cal
care to injured employees while still considering the needs
of the employer.
We at Valley Industrial Hedical Group specialize
industrial medicine exclusively. We have the knowledge,
expertise, and fee schedule that will save the Cit. y of
Bakersfield a substantial amount of taxpayers money and at
the same time provide the City of Bakersfield with a be~ter
more efficient industria], medical service. ·
To further meet the industrial medical needs of our
community Valley Industrial Hedical Group has office hours
from 7:30 A.M. until 7:00 P.H. Monciay thru Friday. In order
to avoid the added expense and inappropriate use of hospital
emergency rooms, Valley Industrial Medical Gr.oup .is on 24
hour call for al]. work related injuries that might occur
after office hours, weekends, or holidays.
Dr. Willard Christensen .has been the City of Bakersfield
industrial, medicine physician for the last three years.
I understand fro.m your conversation with Jimmy that the open
bidding process for the City of Bakersfield account is held
every three years. We have spoken with some. department heads
within .the City of Bakersfield who feel that a c},a~,ge .is
needed at .this time. I do not wish to divulge their names or
positions at this time since this may jeopardize their
positions with the City of Bakersfield. Concerns raised by
these department heacis consisted of higher ].it|gaL|on rates
,
for [he City of Bakersfield legal department for workers
compensation claims, excessive fees~ and conflict of interest
· 2501 "G~' Street · Bakersfield, CA 93301 · (805) 327-2225
businesses t.hat are owned by Dr. Christenscn, :i.e.
California Physical Medicine Associates, California Work
Diagnostic & Rehab Center, and California Thermographic
Associates.
My Administrative Director, Stefanie Cho, recently spoke with
tile City Manager, Dale Hawley, .as to whether or not tile City
of Bakersfield will open the bidding process this year to
find an industrial medical service to better meet tile needs
of the City of Bakersfield and the taxpayers. She also
requested from him expenditure figures for the last three
years by the City of Bakersfield for industrial injuries seen
by Dr. Christensen, for industrial injuries seen at Memorial
tlospital Emergency Room, physical therapy, pre-placement
physical examinations, thermograms, and MRI scans. He gave
Stefanie tile run-around and then referred her to Sue
Whitfield in personnel who he said made the decision whether
or not the bidding process was to be opened and would have
tile figures that had been requested regarding the City
expenditures. Stefanie called Sue, informed her that Dale
Hawley had referred us to her', and again requested tile above
information. Sue was quite surprised and stated that Dale
Hawley was the person that made tile decision as to whether or
not the. bidding process was opened. She then stated that she
would have to make some phone calls to clarify matters and
then would call us back.
She returned our call later that same day stal:ing that she
had .spoken with Dale Hawley who told her ~hat he has
departmental meetings all the time and that everyone, was
happy with Dr. Cl!ristensen. She also told us that he had
made the decision not to re-open tile bidding process since
everyone was happy with Dr. Christensen. Stefanie then asked
Sue why she was referred to talk with her by Dale when in the
end Dale Hawley made the final decision. Sue then stated
that she did not know. Stefanie then requested copies of
City expenditures for industrial medical care over the last
two years to perform a cost analysis. Sue replied that since
the bidding process was not going to be re-opened that those
figures were not public information.
Jimmy called Dale Hawley tile following morning questioning
his decision not to re-open the bidding process without
further knowledge of our industrial medical service. He
invited Dale Hawley to tour our office, meet ns, and see
first hand all the services we offer in comparison to Dr.
Christensen in the hopes that he would re-open the bidding
process. He flatly refused to speak with us. He also added
that it has taken Dr. Christensen three years to learn the
City of Bakersfield system and that to change now would
require another physician to re-learn a system with which we
are already quite familiar. He continued to give Jimmy one
excuse after,.another and ~ was completely uncooperative in
answering his. questions.
I find it .extremely disconcerting to know that my tax dollars
as well as y~rs are paying close-minded people such as Dale
Hawley and Sue Whitfield who do not seem the least bit
interested in seeking out better ways to spend taxpayer's
money but instead are satisfied with the Status quo. Whether
their actions are politically motivated or not remains to be
seen. I also question being told by Sue that the City of
Bakersfield expenditUre figures are not public information,
especially since Mr. Hawley didn't seem to have any problems
divulging figures about private health care costs to the City
in last nights City Council meeting which I attended.
In last nights City Council n~eeting there seemed to be great
concern regarding rising ttealth and Dental Benefit costs ~o
the City. I believe that Health Net was mentioued as the
City's present private patient plan. Yet in speaking with
Dale Hawley and Sue Whitfield there seems to be no interest
whatsoever in containing the indus[rial medical costs to the
City which can be exhorbitant if not controlled.
I believe that Valley Industrial Medical Group can save the
City of Bakersfield taxpayer's money and at the same time
provide a better more efficient industrial medical service in
the following ways:
1. Our workers' compensation charges for injuries are 3-5%
less than Dr. Christensen's.
2. Our physical' examination fees are 50-100~ less than Dr.
Christensen' s.
3. Our after hour, weekend, and holiday fees for
industrial injuries are a~ leas~ 27% less tha,~ Memorial
Itospital's usual and customary emergency room fees.
The City of Bakersfield uses Memorial Hospital after
hours since Dr. Christensen does not take call 2~ buurs
a day. Dr. Christensen also charges another initial
fee once the patient is referred back to him for follow-
up. You therefore have two initial charges on the same
patient if that patient is seen at Memorial tlospital ER
first. Since Valley Industrial Medical Group is on 24
hour call there would o,~ly be one initial, charge and no
dupl.ication of charges thereafter. The City, however,
does have a:special rate of 15% off Memorial. tlospital's
usual and customary emergency room fees. This is still
much higher than our fee schedule for the same services.
4. I am the sole owner of Valley Industrial Medical Group.
Since I am of Asian descent, Valley Industrial Medical
Group is considered a Disadvantaged Business Enterprise.
Valley Industrial Medical Group is presently a Certified
Disadvantaged Business Enterprise (DBE). The policy of
the Bakersfield DBE Program is to tltilize I)BEs in
aspects'of'contracting to the maximum extent feasible
and consistent with law for .any program or facility
funded wholly or ill part with Federal Gover~ment Funds.
Please see the Bakersfield DBE Program Po]icy Sta[~ement
enclosed with this letter. It. is to %.he City of
Bakersfield's advantage to use a DBE ~vhenever possible
to insure continued Federal Government aid funding of
City of Bakersfield projects.
5. I do not own any other business interests that present
a conflict of interest unlike Dr. Chris te~sen. I
presently service many companies formerly using
Christensen. These companies felt that l)r. Christense~
was over-utilizing his California Physical Medic[ne
Associates business for physical therapy and his
California Work diagnostic & Rehab Center for physical
therapy and rehabi, litatio~ at their expense.
Mr. Peterson I am requesting the following items from the
City of Bakersfield to make a cost analysis and confirm
tile ver'acity of my statements above:
1. Itemized statements and dates of charges for workers'
compensation injuries billed to the City of Bakersfield
(City) by Dr. Christensen over the last three years.
2 Itemized statements and dates of charges for ~orkers'
compensation injuries seen after hours at; MemorJ al
Hospital Emergency Room over the last three )rears
that were billed to the City.
3. Itemized statements and dates of charges 'for physical
therapy rendered to workers' compensation injuries
from Dr. Christensen' s California Physical Medicine
Associates and California Work Diagnostic & Rehab
Center over tile last three )rears that were billed
the City.
4. Itemized statements and dates of charges for
thermograms and MRI scans billed to the City from Dr.
Christensen over the last three years.
5. Itemized statements and dates of charges of all pre-
placement physical examinations billed to tile City
from Dr. Christensen over the last three years.
6. The percent of workers' compensations (:].aims th.a[, have
been litigated since-Dr. Christensen has taken over the
City account.
7. The number or percentage of employees with the City
requesting to see a physician other than Dr.
Christense.n.
I would appreciate your complete investigation of ~.his
matter. I am greatly concerned as a taxpaying citizen when
City officials paid with our tax dollars are not interested
in saving those tax dollars, especially when there is a
better alternative. In this day of continually rising health
care costs I believe that it is the City's fiscal
responsibili[y to it's taxpayers to seek out that facility
· that would best meet the City's policy of cost containment.
I feel that the bidding process should be re-opened by the
City to find a better, more cost effective and efficien~
industrial medical service than the City is presently
receiving from Dr. Christensen.
Thank you for your time and attention taken to address this
issue. Should you require further comment or have any
questions, please do not hesitate to contact me directly.
I would also like to extend you a personal invitation ~o tour
our office and speak with us.
Respectfully,
LarrY'S. Cho, M.D.
Medical Director
Enclosure
LMC:lc