CONTRACT 3912G Amendment CLOSEDAgreement No. 3912G
SEVENTH AMENDMENT TO
AGREEMENT NO. 3912 BETWEEN
THE CITY OF EL SEC UNDO AND
WESTCHESTER MEDICAL GROUP /CENTER FOR HEART AND HEALTH
THIS 7TH AMENDMENT ( "Amendment") is made and entered into this First day of October,
2015, by and between the CITY OF EL SEGINDO, a general law city and municipal corporation
existing under the laws of California ( "CITY "), and WESTCHESTER MEDICAL
GR01.MCENTER [OR HEART AND 1 °HEAL "171-1, a General Partnership ( "CON ULJA.NT ").
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, 2016.
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.
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. Amount not to exceed $60,000.00,
IN WITNESS WHEREOF the parties hereto have executed this amendment the day and
year first hera inabove written.
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APPROVED AS TO FORM:
MARK D lj'SLEY, City Attorney
By;
80, David King, A nt City Attorney
WESTCHESTER MEDICAL GROUP/
CENTER FOR I -HBART AND HEALTH
ell
Robert A, Reiss, M.D., F.A.C.P,
Co- Medical Director, Partner
Taxpayer ID No.
EXHIBIT "A"
PERFORMANCE OF SERVICES
Agreement No. 3912G
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 off" ' "Fitness for Dut
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 Physiologist 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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Agreement No. 3912G
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
o 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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Agreement No. 3912G
CONTRACTOR RATES
EVALUATION COMPONENT I Executive, Police, Fire
Physician Examination $200.00
Vision $15.00
Audiometry $10.00
Chest x -ray (1 view) $35.00
Blood panel includes: $53.00
Chemistry panel
Complete blood count
Prostate Specific Antigen As needed /recommended
Urinalysis $12.00
Pulmonary function (FEV, FVC) $25.00
Resting EKG $50.00
Stress EKG (Bruce protocol) $150.00
Strength & Flexibility $20.00
Body composition $10.00
Report to El Segundo "Fit for Duty" Report Form Only
Report to patient No charge
Total cost: 1 $580.00 1
City discount cost: 1 $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
Colonoscopy
Referral Only
Mammogram
Referral Only
Cardiology consultation
Referral Only
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