CONTRACT 3912D Amendment CLOSEDLA,�n
FOURTH AMENDMENT TO
AGREEMENT NO. 3912 BETWEEN
THE CITY OF EL SEGUNDO AND
WESTCHESTER MEDICAL GROUP /CENTER FOR HEART AND HEALTH
THIS 4TH AMENDMENT ( "Amendment ") is made and entered into this First day of October,
2012, by and between the CITY OF EL SEGUNDO, a general law city and municipal corporation
existing under the laws of California ( "CITY "), and WESTCHESTER MEDICAL
GROUP /CENTER FOR HEART AND HEALTH, a General Partnership ( "CONSULTANT ").
1. Pursuant to Agreement No. 3912 ( "Agreement"), executed by the parties on or about
February 25, 2009 and subsequently amended, the term of the agreement is extended
until September 30, 2013.
2. This Amendment may be executed in any number of counterparts, each of which will be
an original, but all of which together constitute one instrument executed on the same
date.
3. Except as modified by this Amendment, all other terms and conditions of Agreement
No. 3912 remain the same.
4. Exhibit A is incorporated by reference.
IN WITNESS WHEREOF the parties hereto have executed this contract the day and year
first hereinabove written.
CITY EL SEGUNDO WESTCHESTER MEDICAL GROUP/
14 CE R HEART AND HEALTH
ATTEST:
M
Robert A. Reiss, M. .A.C.P.
Co- Medical Director, Partner
�i Taxpayer ID No. ice` y
APPROVED A TO
MARK D. H LE C l orney
Y:
Ka, H. Berger, Assjit nt City
Attorney
MBIBIT A °
PERFORMANCE OF SERVICES
• A physical examination by a physician will always include, but not limited to, the following:
1. HEENT (Head, Ears, Eyes, Nose and Throat).
2. Cardiopulmonary examination.
3. Abdominal examination.
4. Musculoskeletal examination.
5. Vascular examination.
6. Neurological status examination.
7. Vital Signs.
8. Upper /Lower extremity exam for mobility and strength.
9. Digital rectal examination and fecal occult blood for males 40 years of age and older,.
10. Testicular examination for males.
11. Breast examination and Pap smear will be offered to females.
12. Family and Personal Medical History.
13, Social /personal history to discuss exercise, diet, alcohol intake, tobacco usage, and
perceived stress level.
14, Review of all laboratory data, x- ray(s), pulmonary function tests, audiometry results,
and resting /exercise EKG interpretation.
15. Discuss preventative health measures that are specific to each examinee.
16. Final recommendations provided in a detailed report to examinee and only a "Fitness
For leg " report form will be provided to the City of El Segundo,
Each examinee will work one -on -one with an Exercise Physiologist throughout the testing
protocol. The Exercise Physiologists on staff are well trained in every aspect of the testing
protocol. This allows for a timely and comfortable transition through the physical. It also allows
the Exercise Physiologist to get to know the examinee to help assist in developing an appropriate
exercise prescription and advise lifestyle modifications per conversations with that examinee.
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SERVICE COMPONENTS PROVIDED AS PART OF THE
CITY OF EL SEGUNDO EXECUTIVE HEALTH AND FITNESS PROGRAM
• A physical examination by a physician
• Blood Analysis (chemistry panel, complete blood count, thyroid, blood type, prostate
specific antigen)
• Urinalysis
• Hemoccult slide testing
• Height /Weight measurement
• Body Composition Analysis
• Vision Testing (Titmus /Snellen)
• Color vision (Ishihara/Farnsworth)
• Hearing Test (Audiogram 500Hz — 8000Hz)
• Pulmonary Function Testing
• Chest x -ray (1- view /2 views)
• Back x -rays when applicable
• Resting EKG
• Maximal Stress EKG (treadmill or bike)
• Push -up evaluation
• Curl -up evaluation
• Flexibility evaluation (Acuflex I — "sit & reach ")
• Vaccinations, immunizations, antibody testing, etc. upon request.
• Follow -up or referral to health care practitioner
• Counseling, after the examination, by both the physician and Exercise Physiologist to
review the results that are available, discuss exercise and dietary guidelines, and ways to
reduce risk factors for heart disease.
• A report with all laboratory /x -ray results, exercise prescription and physician
recommendations will be mailed to examinee.
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CONTRACTOR RATES
EVALUATION COMPONENT I Executive, Police, Fire
Physician examination
$200.00
. . .............. ...........
Vision . . .
.................................. ........ $15.00
Audiometry .... . . . ..... ......... . ...... . . ....... .
. ........... $10.00
Chest x-ray (1 view)
........_._- ...W....
$35.00
Blood panel includes:
$53.00
Chemistry panel
.. . Negotiable
Complete blood count
$40.00
.......... ...... . . . ... ..............
Prostate Specific Antigen
As needed/recommended
Urinalysis
$12.00
............. . .... . . . . .......
Pulmonary function FEV, FVQ
....... ....
$25.00
Resting EKG
$50.00
Stress EKG (Bruce protocol)
$150.00 . .. ........................ ...........
Strength & flexibility
$20.00
Body comoosition . . . ................................ . . ......
$10.00
Report to El Segundo
"Fit for Duty" Report Form Only
Report to patient
No charge
Total Cost: $580.00
. ......................... .. .. . . . ...... . . ....... . . ......
Citv discount cost: $450.00
. ..... . ....
Additional Components:
�Resting EKG & Stress test (a la carte)
$200.00
Chest x-ray (2 views—PA/Lateral)
.
$65.00
... ....... ................ —
TB Skin Test (PPD). Includes admin. fee
and supplies.
$65.00
... ........ . ......... . . . .............. ...........
Hepatitis A (2 doses)
Negotiable
Hepatitis B (3 doses) . . .................
.. . Negotiable
Hepatitis C Antibody
$40.00
.......... ...... . . . ... ..............
Hepatitis B Surface Antibody
$......
37.00
....... ........... . ....... ................
Immunizations ...... . . . .................. . ..... . . ....................... ..
. . . ..... Negotiable
Vaccinations ... .......... . . . . . .........................
Negotiable
Pap smear_ . .... ... ...... . ........ ........... ...... . . . ................ . . ............ . . .
Referral only
Colonoscol)-v
Referral only
Mammogram
.. ....... ..........
Referral only
Cardiology consultation
Referral only
Agreement active from October 1, 2012 through September 30, 2013.
461
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