HomeMy WebLinkAboutR-2013-102 Heartland Occupational Medicine Physical Testing Services RESOLUTION NO. R- 2013 -102
A RESOLUTION APPROVING AN AGREEMENT WITH HEARTLAND OCCUPATIONAL
MEDICINE REGARDING POST - OFFER, PRE - EMPLOYENT PHYSICAL TESTING SERVICES
BE IT RESOLVED BY THE BOARD OF ALDERMEN OF THE CITY OF RIVERSIDE,
MISSOURI AS FOLLOWS:
THAT the Board of Aldermen ( "Board ") approves the Agreement for Physical Capacity
Profile Testing, in substantially the form attached hereto as Exhibit A, with Heartland
Occupational Medicine, and authorizes the Mayor Pro Tem to execute the Agreement on behalf
of the City; and
FURTHER THAT the Mayor Pro Tem, the City Administrator, the City Attorney and other
appropriate City officials are hereby authorized to take any and all actions as may be deemed
necessary or convenient to carry out and comply with the intent of this Resolution and to
execute and deliver for and on behalf of the City all certificates, instruments, agreements and
other documents, as may be necessary or convenient to perform all matters herein authorized.
PASSED AND ADOPTED by the Board of Aldermen and APPROVED by the Mayor of
the City of Riverside, Missouri, the 3 day of O/cckchr 2013.
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Mayor Pro Tem
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Rep Cittrell,. Gity Clerk
AGREEMENT FOR PHYSICAL CAPACITY PROFILE® TESTING
This Agreement for Medical Examinations and Physical Capacity Profile® Testing, dated
, is between Heartland Occupational Medicine with offices located at 401 Illinois Ave.,
Saint Joseph, MO 64504, and (Co. name and address) herein referred to as "Employer".
Heartland Occupational Medicine and Employer agree to the terms and conditions set forth below:
SECTION 1
SERVICE PROVIDED
1.1 Heartland to Conduct Medical Examinations and Physical Capacity Profile® Testing. Employer
hereby hires Heartland to conduct medical examinations, including Physical Capacity Profile® evaluations, on
employees of Employer, or of those persons given conditional offer of employment with Employer, the purpose
of which is to determine the abilities of the employee to perform the essential functions of a job, with or without
reasonable accommodation. The business necessity for testing the Physical Capacity Profile® of such
employees is to reduce the risk of placing an employee in a position where there is substantial risk of injury to
the employee or others, thereby reducing work - related injuries and potential workers compensation claims of
Employer.
1.2 Requirement That Each Job Classification Have Medical Examinations. It is understood that all
employees entering into a particular job category will undergo the medical examinations and Physical Capacity
Profile') evaluations, regardless of disability.
1.3 Confidentiality of Testing Results. Any information furnished after the medical examinations and
Physical Capacity Profile® evaluation shall be confidential and shall be collected and maintained by Employer
in a separate and confidential medical file the access of which will be limited to: (1) supervisors and managers
needing to determine the necessary restrictions or accommodations for an employee; (2) first aid and safety
personnel; and (3) government officials investigating compliance with the law.
SECTION 2
TERM
The term of this Agreement shall commence upon the date of execution and shall continue for a one (1)
year period unless earlier terminated by either party. The term of this Agreement shall automatically renew for a
successive one (1) year term unless terminated by either party as provided herein in SECTION 5 of this contract.
SECTION 3
FEES
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3.1 Fees. Employer agrees to pay Heartland for contracted services in accordance with the fee schedule
attached hereto as "Schedule of Services" and incorporated herein by reference. Employer understands that
such fee schedule shall be subject to change from time -to -time, provided employer shall have the right to
terminate the Agreement upon written notice to Heartland if any change in such fee schedule is not acceptable to
Employer. Heartland shall give a minimum of thirty (30) days written notice to Employer of any such fee
schedule changes.
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3.2 Time of Payments. Fees shall be due on or before the 10 day of each month. Payments not
received by the 15 day following the due date shall be considered in default.
3.3 Late Charges. Any Payments in default will be charged at the rate of twelve percent (12 %) per
annum or, if lower, at the maximum rate for late charges permitted by law.
SECTION 4
PURPOSE OF TESTING AND GENERAL INDEMNITY
4.1 Physical Capacity Profile® Testing. It is understood that the intended purpose of the testing is to
provide a mechanism by which the Physical Capacity Profile® of employees of Employer, or of those persons
given conditional offers of employment with Employer, may be tested to determine the abilities of the employee
to perform the essential job functions of a job, with or without reasonable accommodations. The business
necessity for testing the Physical Capacity Profile of such employees is to reduce the risk of placing an
employee in a position where there is substantial risk of injury to the employee or others, thereby reducing
work - related injuries and potential workers compensation claims of Employer. As such, Employer shall be
responsible for determining the essential functions of each job for which testing will occur and it is understood
testing will be used to provide objective information with which to evaluate whether an employee has the
Physical Capacity Profile to perform those functions. It is understood that all employees entering into a
particular job category will undergo the evaluation with the equipment, regardless of disability. Any information
furnished after the Physical Capacity Profile® evaluation shall be collected and maintained by employer in a
separate and confidential medical file the access of which is limited to: (1) supervisors and managers needing to
determine the necessary restrictions or accommodations for an employee; (2) first aid and safety personnel; and
(3) government officials investigating compliance with the law. As between Employer and its employees, it is
understood that the Employer shall be solely responsible for determining whether a tested employee can or
cannot be accommodated in the workplace or whether reasonable accommodations can or cannot be made under
applicable federal and state disabilities laws. Employer represents and warrants that it shall use the information
obtained by the testing in compliance with the Americans with Disabilities Act and any other applicable
disability discrimination laws and that it will not utilize the information to discriminate against an employee or
person offered a conditional offer of employment. Employer further represents it will comply with all applicable
laws and regulations, specifically including the privacy and security standards of the Health Insurance
Portability and Accountability Act of 1996 ( "HIPAA "), as amended from time to time. Employer shall
indemnify and hold OPC harmless from any and all claims made by any employee or prospective employee of
any rights under any employment or disability discrimination laws.
(Updated 5/2003)
4.2 HIPAA Compliance. Employer will comply with all applicable provisions of the Health
Insurance Portability and Accountability Act ( "HIPAA ") insofar as it applies with respect to protecting the
confidentiality of protected health information of employees. Employer, its agents and employees (collectively,
"User "), acknowledges that User may have access to confidential protected health information ( "PHI "),
including, but not limited to, patient identifying information. User agrees that it: (1) will not use or further
disclose PHI other than as permitted by this Agreement or required by law; (2) will protect and safeguard from
any oral and written disclosure all confidential information regardless of the type of media on which it is stored
(e.g., paper, fiche, etc.) with which it may come in contact; (3) will use appropriate safeguards to prevent use or
disclosure of PHI other than as permitted by this Agreement or required by law; (4) will ensure that all of its
subcontractors and agents to which it provides PHI pursuant to the terms of this Agreement shall agree to all of
the same restrictions and conditions to which User is bound; (5) will report to OPC any unauthorized use or
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disclosure immediately upon becoming aware of it, (6) will indemnify and hold OPC harmless from all
liabilities, costs and damages arising out of or in any manner connected with the disclosure by User of any PHI;
(7) will make available PHI in accordance with 45 C.F.R. §164.526; (8) will make available the information
required to provide an accounting of disclosures in accordance with 45 C.F.R. §164.528; (9) will make its
internal practices, books and records relating to the use and disclosure of PHI received from, or created or
received by one party on behalf of the other available to the Secretary of Health and Human Services,
governmental offices and agencies and OPC for purposes of determining compliance with 45 C.F.R. §164.500-
534; (10) upon termination of the Agreement, for whatever reason, will return or destroy all PHI, if feasible,
received from, or created or received by it on behalf of OPC which User maintains in any form, and retain no
copies of such information, or if such return or destruction is not feasible, to extend the precautions of their
Agreement to the information and limit further uses and disclosure to those purposes that make the return or
destruction of the information infeasible; and (11) will comply with all applicable laws and regulations,
specifically including the privacy and security standards of the Health Insurance Portability and Accountability
Act of 1996 ( "HIPAA "), as amended from time to time. User recognizes that any breach of confidentiality or
misuse of information found in and/or obtained from records may result in the termination of this agreement
and/or legal action. Unauthorized disclosure may give rise to irreparable injury to the patient or to the owner of
such information and accordingly the patient or owner of such information may seek legal remedies against
User.
4.3 Risk of Injury to Employees. Employer understands that Physical Capacity Profile testing
potentially places employees being tested at risk for injury. Employer acknowledges that if an employee is
injured during testing, a worker's compensation claim might arise. Employer agrees that it will indemnify and
hold Heartland harmless against any claims arising from injuries which occur to employees during the
utilization of the equipment.
SECTION 5
TERMINATION
This Agreement is terminable by either party upon 30 days advance, written notice delivered at the
address specified in the first paragraph of this Agreement.
SECTION 6
MISCELLANEOUS
6.1 Other Agreements. Heartland and Employer acknowledge that there are no agreements or
understandings, written or oral, between them, and that this Agreement contains the entire agreement between
Heartland and Employer.
6.2 Time of the Essence. Time is of the essence with respect to this Agreement.
6.3 Governing Law. This Agreement and each accompanying schedule shall in all respects be
governed by, and construed in accordance with applicable State Laws.
6.4 Binding Effect. All agreements, representations, indemnities, and warranties made by Employer
in this Agreement shall be for the benefit of Heartland , and shall survive the expirations or sooner
terminations of this Agreement.
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6.5 Supervening Law. If any term or provision of this Agreement is, to any extent, held invalid or
unenforceable, the remainder of this Agreement not held invalid or unenforceable shall not be effected and each
term and provision of this Agreement shall be valid and enforceable to the fullest extent permitted by law.
6.6 Non - Assignment. Either party without the written consent of the other party shall not assign this
Agreement.
6.7 Captions. The captions set forth herein and in each schedule are for convenience only and shall
not define or limit any of the terms.
IN WITNESS WHEREOF, Heartland Occupational Medicine and Employer have caused this
Agreement to be executed on the date indicated below.
Heartland Occupational edicine
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By 5. kek.. 1 ! c ,, abate / ACS, �
Employer
By Li Date /03/2013
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