HomeMy WebLinkAboutPROFESSIONSAL HEALTH SERVICE AGREEMENT BETWEEN AUGUSTA AND UNIVERSITY HEALTH SERVICESI
THIS PROFESSIONAL SERVICES AGREEMENT ( "Agreement ") is made and entered into by
and between the Consolidated Government of Augusta, Georgia ( "Augusta "), and University
Health Services, Inc. ( "Consultant "), with reference to the following:
A. Augusta desires to engage a qualified and experienced medical provider with in -depth
knowledge regarding fire - service specific medical assessments in accordance with the
IAFF/ IAFC Joint Labor Management Wellness Fitness Initiative, the Firefighter Life
Safety Initiative and NFPA 1582: Standard on Comprehensive Occupational Medical
Program for Fire Departments, 2007 Edition to provide consolidated medical
assessment, possible immunizations, and data record - keeping services of all uniformed
personnel of the Augusta Fire Department ( "AFD ").
B. Consultant responded to Augusta's RFP #12 -116 and was chosen as the most qualified
respondent based on its submittal.
NOW, THEREFORE, in consideration of the foregoing, the provisions contained herein and the
mutual benefits to be derived here from, and for other good and valuable consideration, the
receipt and sufficiency of which are hereby acknowledged, Consultant and Augusta agree as
follows:
1. Services and Deliverables.
1.1
PROFESSIONAL SERVICES AGREEMENT
Scope of Work; Communications. Consultant shall provide baseline annual and
preemployment medical exams to all uniformed personnel of the Augusta Fire
Department in accordance with the IAFF/ IAFC Joint Labor Management
Wellness Fitness Initiative, the Firefighter Life Safety Initiative and NFPA 1582:
Standard on Comprehensive Occupational Medical Program for Fire
Departments, 2007 Edition as set forth in Augusta RFP #12-116 Scope of
Services and Price Sheet, which are incorporated herein by reference and attached
hereto as Attachments A and B, respectively, including, but not limited to,
a. Medical and Occupational /Environmental History questionnaire to be
completed by employee & reviewed by Physician;
b. General Physical and Neurological Examination;
c. Complete Blood Count/Differential /Platelet Count;
d. Urinalysis (Routine and Microscopic);
e. Blood Chemistry Profile;
f. Electrocardiogram (12 Lead Stress);
g. Cancer Screening;
h. Chest X -ray (PA) one view;
i. Spirometry/Pulmonary Function Test (FVC, FEV1, (FEV1 /FVC %)); and
j. Visual Acuity.
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1.2 Standard of Performance. Consultant represents and warrants that it has the
necessary knowledge, experience, abilities, skills and resources to perform its
obligations under this Agreement, and agrees to perform its obligations under this
Agreement in a professional manner, consistent with prevailing industry standards
and practices.
1.3 Qualifications, Licenses, and Permits; Compliance with Law. Consultant
represents and warrants that it has all licenses and permits necessary to conduct its
business and perform its obligations under this Agreement, and agrees to comply
with all applicable federal, state and local statutes, regulations, codes, ordinances
and policies in performing its obligations under this Agreement.
1.4 Independent Consultant Relationship. The parties intend that Consultant's
relationship to Augusta in providing services hereunder shall be that of an
independent Consultant. Nothing in this Agreement, nor any performance
hereunder, is intended or shall be construed to create a partnership, joint venture
or relationship of agency or employment between Augusta and Consultant. In
providing services hereunder, Consultant shall represent itself to third parties as
an independent Consultant to Augusta and shall not hold itself out as having any
authority to obligate Augusta. Consultant shall have no authority for any
complaints related to employment with Augusta, Georgia and has no authority to
hire, fire, discipline, or otherwise effect the terms and conditions of Augusta,
Georgia employees, except as specifically set forth herein.
1.5 Confidentiality. Consultant agrees that its conclusions and any reports are for the
confidential use and information of Augusta and that it will not disclose its
conclusions in whole or in part to any persons whatsoever, other than to submit its
written documentation to Augusta, and will only discuss the same with it or its
authorized representatives.
This is to insure that information from medical examinations is not improperly
released and does not subsequently become harmful to uniformed personnel and
their careers while being easily accessible for pre /post comparison in case of a
major disaster.
• The only medical information that may be released to the Fire Chief without
the permission of the firefighter is a report that the firefighter either passed or
failed the medical examination in accordance with NFPA Standard 1582.
• At no time will an individual's medical information be released, or shared,
with any Augusta department and/or any other medical provider without
written authorization by the employee.
• Medical information must be collected in a database that can provide both
aggregate reports as well as specific individual information, that is
electronically secure to only pre- authorized medical providers.
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• The medical provider will identify and retain medical records, in a manner of
their choosing, so that they can be secured as Augusta Fire Fighter personal
medical records.
• Requests for authorization to transfer or destroy any or all of the medical
information must be made in writing to the Firefighter and Fire Chief.
• Aggregate data may be provided to the Fire Chief, to look at general trends, as
long as data from the report cannot lead to the identity of a specific individual.
It is further agreed that if any information should be released by the Consultant
without prior approval from Augusta, the release of same shall constitute grounds
for termination of this Agreement without indemnity to the Consultant, but should
any such information be released by Augusta or by the Consultant with such prior
approval, the same shall be regarded as public information and no longer subject
to the restrictions of this Agreement.
2. Assignment of Rights Regarding Deliverables; Records.
2.1 Assignment. Consultant does hereby assign, grant, and deliver to Augusta, and
Augusta hereby accepts, the entire worldwide right, title, and interest of every
kind and nature whatsoever in and to the deliverables under this Agreement,
including but not limited to any related intellectual property rights.
2.2 Records. Consultant shall maintain throughout the term of this Agreement and
for a period of seven (7) years thereafter records that indicate the date, time, and
nature of the services rendered. Consultant shall make available for inspection by
Augusta all records, books of account, memoranda, and other documents
pertaining to Augusta, except medical records, at any reasonable time upon
request.
2.3 Open Records. Consultant acknowledge that all records relating to this
Agreement and the services to be provided under the contract may be a public
record subject to Georgia's Open Records Act (O.C.G.A. § 50- 18 -70, et seq.).
Consultant shall cooperate fully in responding to such request and making all
records, not exempt, available for inspection and copying as provided by law.
3. Fee; Expenses; Invoicing.
3.1 Fee; Expenses. In consideration of Consultant performing its obligations under
this Agreement, Augusta will pay Consultant amounts as described in Attachment
B hereto.
3.2 Invoicing. Consultant shall submit monthly invoices to the AFD Fire Chief
identifying this Agreement and the amount payable. Payment of undisputed
amounts shall be due and payable thirty (30) days after Augusta's receipt of the
invoice.
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3.3 Georgia Prompt Pay Act Not Applicable. The terms of this Agreement supersede
any and all provisions of the Georgia Prompt Pay Act.
3.4 Defective Pricing. To the extent that the pricing provided by Consultant is
erroneous and defective, the parties may, by agreement, correct pricing errors to
reflect the intent of the parties.
3.5 Prohibition Against Contingent Fees. The Consultant warrants that no person or
selling agency has been employed or retained to solicit or secure this Agreement
upon an agreement or understanding for a commission, percentage, brokerage, or
contingent fee, excepting bona fide employees or bona fide established
commercial or selling agencies maintained by Consultant for the purpose of
securing business and that the Consultant has not received any non- Augusta fee
related to this Agreement without the prior written consent of Augusta. For
breach or violation of this warranty, Augusta shall have the right to annul this
Agreement without liability or at its discretion to deduct from the Agreement
Price of consideration the full amount of such commission, percentage, brokerage
or contingent fee.
4. Term; Termination; Survival.
4.1 Term. This Agreement shall have an initial term of two years commencing on
January 1, 2013, and may be extended for three (3) one (1) year terms by written
agreement of the parties unless sooner terminated pursuant to Section 4.2 below.
4.2 Termination. This Agreement may be terminated prior to the completion of
Consultant's services (i) upon ninety (90) days written notice to the other party, or
(ii) by either party upon a breach of this Agreement (including, but not limited to,
Consultant's services being deemed unsatisfactory by Augusta) by the other party
that remains uncured ten (10) days after receiving written notice of such breach
from the terminating party. This Agreement may be terminated immediately if
Consultant fails to maintain insurance or fails to comply with the Workers'
Compensation Act and applicable rules as described in Section 6.1 herein. In the
event of a termination of this Agreement pursuant to this Section 4.2, Augusta and
Consultant will in good faith negotiate an appropriate reduction in the fees
payable to Consultant pursuant to Section 3.1 above.
4.3 Liquidated Damages. Consultant agrees to pay as liquidated damages to Augusta
the sum of $10 for each consecutive calendar day after expiration of the
Agreement Term, except for authorized extensions of time by Augusta. This
Section is independent of Section 4.2 regarding default by Consultant. The
Parties agree that these provisions for liquidated damages are not intended to
operate as penalties for breach of contract. The liquidated damages set forth
herein are not intended to compensate Augusta for any damages other than
inconvenience and loss of use or delay in services. The existence or recovery of
such liquidated damages shall not preclude Augusta from recovering other
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4.4 Survival. Notwithstanding anything in this Agreement to the contrary, the
provisions of Section 5 below shall survive any expiration or termination of this
Agreement, and each party shall remain obligated to the other party under all
provisions of this Agreement that expressly or by their nature extend beyond and
survive the expiration or termination of this Agreement.
4.5 Temporary Suspension or Delay of Performance of Contract. To the extent that it
does not alter the scope of this Agreement, Augusta may unilaterally order a
temporary stopping of the work, or delaying of the work to be performed by
Consultant under this Agreement.
4.6 Specified Excuses for Delay or Non - Performance. Neither Augusta, nor
Consultant, shall be liable for any delay in the performance of this Agreement,
nor for any other breach, not for any loss or damage arising from uncontrollable
forces such as fire, theft, storm, war, or any other force majure that could not have
been reasonably avoided by the exercise of due diligence.
5. Indemnification.
damages in addition to the payments made here under which Augusta can
document as being attributable to the documented Consultant failures. In addition
to other costs that may be recouped, Augusta may include costs of personnel and
assets used to coordinate, inspect, and re- inspect items within this Agreement, as
well as attorney fees, if applicable.
5.1 Indemnification. Consultant shall indemnify, hold harmless, protect and defend
Augusta and its Commissioners, elected officials, trustees, officers, employees,
agents, and representatives (the "Indemnified Parties ") for, from and against any
and all demands, claims, suits, damages, losses, liabilities, costs and expenses,
including, but not limited to, court costs and attorneys' fees (the "Indemnified
Matters "), of any nature whatsoever (including, but not limited to, damage to or
loss of property, bodily injury or death), directly or indirectly arising out of or in
connection with the performance of Consultant's obligations under this
Agreement. Consultant's indemnification obligations under this Section 5.1 shall
apply whether the Indemnified Matters are due in part to the concurrent fault or
negligence of the Indemnified Parties or others, but shall not extend to such
concurrent fault or negligence. Consultant's defense obligations under this
Section 5.1 shall be with attorneys approved by Augusta, which approval shall not
be unreasonably withheld.
6. Insurance.
6.1 Consultant shall, at all times that this Agreement is in effect, cause to be
maintained in force and effect an insurance policy(s) that will ensure and
indemnify Augusta against liability or financial loss resulting from injuries
occurring to persons or property or occurring as a result of any negligent error,
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7. Miscellaneous.
act, or omission of the Consultant in performance of the work during the term of
this Agreement. Consultant shall provide, at all times that this Agreement is in
effect, insurance with limits of not less than:
A. Workmen's Compensation Insurance in accordance with the State of Georgia;
B. Public Liability Insurance in an amount of not less than One Million
($1,000,000) Dollars for injuries, including those resulting in death to any one
person, and in an amount of not less than One Million ($1,000,000) Dollars on
account of any one occurrence;
C. Property Damage Insurance in an amount of not less than One Million
($1,000,000) from damages on account of an occurrence, with an aggregate
limit of One Million ($1,000,000) Dollars; and
D. Professional Liability Insurance in an amount of not less than One Million
($1,000,000) Dollars or an amount that correlates to the aggregate fee on the
project should it exceed $1,000,000.
7.1 Power and Authority; Due Authorization; No Conflict; Enforceability. Each party
represents and warrants to the other party that (i) such party has the power and
authority to execute, deliver and perform its obligations under this Agreement, (ii)
the execution, delivery and performance of this Agreement have been duly
authorized by such party and do not and shall not conflict with any agreement or
instrument to which it is bound, and (iii) this Agreement constitutes the legal,
valid and binding obligation of such party, enforceable against it in accordance
with its terms.
7.2 Entire Agreement; Severability; Further Assurances. This Agreement, including
any exhibits attached hereto, constitutes the entire agreement between the parties,
and supersedes all prior and contemporaneous agreements, understandings and
negotiations, with respect to the subject matter hereof. In the event any provision
of this Agreement is determined to be invalid or unenforceable, it is the desire and
intention of the parties that such invalidity or unenforceability not invalidate or
render unenforceable the remainder of the Agreement and that such provision be
reformed and construed in such a manner that it will, to the maximum extent
practicable, be deemed valid and enforceable, and the rights and obligations of the
parties shall be construed and enforced accordingly. Each party shall execute and
deliver such further documents and take such further actions as may be required
or reasonably requested by the other party to effectuate the purposes of this
Agreement.
7.3 No Assignment; No Amendment; No Waiver. This Agreement (i) may not be
assigned or transferred, in whole or in part, by operation of law or otherwise, by
either party without the prior written consent of the other party, and (ii) may not
be amended or modified, by course of conduct or otherwise, except in a writing
duly executed by each of the parties. Consultant acknowledges that this contract
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and any changes to it by amendment, modification, change order or other similar
document may have required or may require the legislative authorization of the
Board of Commissioners and approval of the Mayor. Under Georgia law,
Consultant is deemed to possess knowledge concerning Augusta's ability to
assume contractual obligations and the consequences of Consultant's provision of
goods or services to Augusta under an unauthorized contract, amendment,
modification, change order or other similar document, including the possibility
that the Consultant may be precluded from recovering payment for such
unauthorized goods or services. Accordingly, Consultant agrees that if it provides
goods or services to Augusta under a contract that has not received proper
legislative authorization or if the Consultant provides goods or services to
Augusta in excess of the any contractually authorized goods or services, as
required by Augusta's Charter and Code, Augusta may withhold payment for any
unauthorized goods or services provided by Consultant. Consultant assumes all
risk of non - payment for the provision of any unauthorized goods or services to
Augusta, and it waives all claims to payment or to other remedies for the
provision of any unauthorized goods or services to Augusta, however
characterized, including, without limitation, all remedies at law or equity. Any
waiver of any provision of this Agreement shall be in writing duly executed by
the waiving party. The failure or delay by either party to seek redress for any
breach or default under this Agreement, or to insist upon the strict performance of
any provision of this Agreement, shall not constitute a waiver thereof or of any
other provision of this Agreement, and such party shall have all remedies
provided herein and at law and in equity with respect to such act and any
subsequent act constituting the same.
7.4 Notice. Any notices required under this Agreement shall be made in writing,
postage prepaid to the following addresses, and shall be deemed given upon hand
deliver, verified delivery by telecopy (followed by copy sent by United States
mail), or three (3) days after deposit in the United Stated Mail:
Augusta:
Courtesy copy to:
Consultant:
Fire Chief
Augusta Fire Department Administration
3117 Deans Bridge Road
Augusta, Georgia 30906
General Counsel
Augusta Law Department
520 Greene Street
Augusta, Georgia 30901
Karen Key
Manager, Occupational Health Services
University Hospital
3121 Peach Orchard Road, Suite 201
Augusta, Georgia 30906
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7.5 Right to Inspect Premises. Augusta may, at reasonable times, inspect the part of
the plant, place of business, or work site of Consultant or any subcontractor of
Consultant or subunit thereof which is pertinent to the performance of any
contract awarded or to be awarded by Augusta.
7.5 Local Small Business Program. In accordance with Chapter 10B of the
AUGUSTA, GA. CODE, Contractor expressly agrees to collect and maintain all
records necessary to for Augusta, Georgia to evaluate the effectiveness of its
Local Small Business Opportunity Program and to make such records available to
Augusta, Georgia. The requirements of the Local Small Business Opportunity
Program can be found at www.augustaga.gov. In accordance with AUGUSTA, GA.
CODE § 1- 10- 129(d)(7), for all contracts where a local small business goal has
been established, the contractor is required to provide local small business
utilization reports. Contractor shall report to Augusta, Georgia the total dollars
paid to each local small business on each contract, and shall provide such
payment affidavits, regarding payment to subcontractors as may be requested by
Augusta, Georgia. Such documents shall be in the format specified by the
Director of minority and small business opportunities, and shall be submitted at
such times as required by Augusta, Georgia. Failure to provide such reports
within the time period specified by Augusta, Georgia shall entitle Augusta,
Georgia to exercise any of the remedies set forth, including but not limited to,
withholding payment from the contractor and/or collecting liquidated damages.
7.6 Governing Law; Jurisdiction and Venue; Attorneys' Fees. This Agreement shall
be governed by, and construed and enforced in accordance with, the laws of the
State of Georgia (without regard to the conflicts or choice of law principles
thereof). The parties irrevocably consent to the jurisdiction of the State of
Georgia, and agree that the Superior Court of Richmond County, Georgia, shall
be an appropriate and convenient place of venue to resolve any dispute with
respect to this Agreement. In the event either party commences any proceeding
against the other party with respect to this Agreement, the parties agree that
neither party shall be entitled to recover attorneys' fees except as otherwise
specifically provided for by law.
7.7 Construction of Agreement. The parties acknowledge and agree that both parties
substantially participated in negotiating the provisions of this Agreement; and,
therefore, the parties agree that this Agreement shall not be construed more
favorably toward one party than the other party as a result of one party primarily
drafting the Agreement. The section and other headings in this Agreement are for
convenience of reference only and shall not be construed, expressly or by
implication, so as to affect the meaning or interpretation of any of the provisions
hereof. This Section and other headings in this Agreement are for convenience of
reference only and shall not affect, expressly or by implication, the meaning or
interpretation of any of the provisions hereof.
7.8 Counterparts. This Agreement may be executed in counterparts, each of which
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CONSULTANT
AUGUSTA, GEORGIA
David S. Copenhaver
Mayor
shall be deemed an original, but all of which taken together shall constitute one
and the same instrument.
IN WITNESS WHEREOF, Consultant and Augusta have duly executed and delivered this
Agreement.
Marilyn Bowcutt � Date
Chief Operating O icer/Vice President
University Health, Inc.
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:
(t- c ?�
Date
ATTACHMENT A — SCOPE OF SERVICES
PROJECT DESCRIPTION:
The program requires a medical provider with in -depth knowledge regarding fire - service specific
medical assessments in accordance with the IAFF/ IAFC Joint Labor Management Wellness
Fitness Initiative, the Firefighter Life Safety Initiative and NFPA 1582: Standard on
Comprehensive Occupational Medical Program for Fire Departments, 2007 Edition to provide
consolidated medical assessment, possible immunizations, and data record - keeping services of
all incumbent uniformed personnel.
PROGRAM GOALS /OBJECTIVES:
The Baseline Medical Evaluation is designed to accomplish the following services in accordance
to NFPA Standard 1582: Standard on Comprehensive Occupational Medical Program for
Fire Departments, 2007 Edition
•To provide a cost - effective investment in the early detection, disease prevention, and health
promotion of Augusta Fire Fighters
•To create baseline data to monitor future effects of exposure to specific biological, physical, or
chemical agents.
•To detect changes in an individual's health that may be related to harmful working conditions
•To provide the uniformed personnel with information about the individual's occupational
hazards and current health
•To comply with federal, state, and local requirements.
•To limit out -of- service time through preventative early intervention of potential problems
•To recommend types of case - management/rehabilitation for injuries to decrease re- injury rates
The Annual Firefighter Medical Evaluation is designed to accomplish the following services in
accordance to NFPA Standard 1582: Standard on Comprehensive Occupational Medical
Program for Fire Departments, 2007 Edition
• To provide a cost - effective investment in the early detection, disease prevention, and
health promotion of Augusta Fire Fighters
• To detect changes in an individual's health that may be related to harmful working
conditions
• To provide the uniformed personnel with information about the individual's occupational
hazards and current health
• To comply with federal, state, and local requirements.
• To limit out -of- service time through preventative early intervention of potential problems
Pre - employment Medical Evaluation is designed to accomplish the following services:
• To insure that the candidate for employment meets all medical and physical requirements
for employment as specified in NFPA Standard 1582: Standard on Comprehensive
Occupational Medical Program for Fire Departments, 2007 Edition
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• To provide a cost - effective investment in the early detection, disease prevention, and
health promotion of Augusta Fire Fighters
• To create baseline data to monitor future effects of exposure to specific biological,
physical, or chemical agents.
• To comply with federal, state, and local requirements.
PROJECTED WORKLOAD
Uniformed personnel of the Augusta Fire Department consist of:
• Fire Chief -1
• Assistant Chiefs - 1
Deputy Chiefs - 2
• Battalion Chiefs - 14
• Captains- 21
• Lieutenants — 60
• Sergeants- 60
• Firefighters — 170
MEDICAL INFORMATION SYSTEM /CONFIDENTIALITY
This is to insure that information from medical examinations is not improperly released and does
not subsequently become harmful to uniformed personnel and their careers while being easily
accessible for pre /post comparison in case of a major disaster.
• The only medical information that may be released to the Fire Chief without the
permission of the firefighter is a report that the firefighter either passed or failed the
medical examination in accordance with NFPA Standard 1582.
• At no time will an individual's medical information be released, or shared, with any
AUGUSTA department and/or any other medical provider without written authorization
by the employee.
• Medical information must be collected in a database that can provide both aggregate
reports as well as specific individual information, that is electronically secure to only pre -
authorized medical providers.
• The medical provider will identify and retain medical records, in a manner of their
choosing, so that they can be secured as Augusta Fire Fighter personal medical records.
• Requests for authorization to transfer or destroy any or all of the medical information
must be made in writing to the Firefighter and Fire Chief.
• Aggregate data may be provided to the Fire Chief, to look at general trends, as long as
data from the report cannot lead to the identity of a specific individual.
GENERAL OVERVIEW OF TASK TO BE PERFORMED
1. Medical and Occupational/Environmental History questionnaire to be completed by
employee & reviewed by Physician.
2. General Physical and Neurological Examination
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3. Complete Blood Count/Differential/Platelet Count
4. Urinalysis (Routine and Microscopic)
5. Blood Chemistry Profile
6. Electrocardiogram (12 Lead Stress)
7. Cancer Screening
8. Chest X -ray (PA) one view
9. Spirometry/Pulmonary Function Test (FVC, FEV1, (FEV1/FVC %)
10. Visual Acuity
ATTACHMENT B - COMPENSATION /PRICE LIST
PRICE QUOTATIONS & PROTOCALS
Price Per Year 1 Year - $125,349
2nd Year - $125,349
Third Year Increase Percentage 5.00%
Fourth Year Increase Percentage 5.00%
(above 3 Year Pricing)
PRICE SHEET
The decision to implement any listed items rests with the fire department, not the
organization /individual providing these services.
Individualized Health Risk Appraisal $ Included w/ Physical
Written feedback to uniformed personnel concerning health risks and health status is required
following the annual examination. Reporting findings and risks and suggesting plans for modifying
risks improves the physician - patient relationship and helps uniformed personnel claim ownership of
their health status. Individualized health risk appraisals also must include questions that attempt to
accurately measure the uniformed personnel's perception of their health. Health perception can be a
useful indicator of potential problems.
Medical History Questionnaire $ Included w/ Physical
An initial pre - employment history questionnaire must be completed to provide baseline information
with which to compare future medical concerns.
Hands -on Physical Examination $ 79.00
To Include:
Vital Signs - Head, Neck, Eyes, Ears, Nose, and Throat
Cardiovascular - Inspection, auscultation, percussion and palpation.
Pulmonary - Inspection, auscultation, percussion and palpation.
Gastrointestinal - Inspection, auscultation, percussion and palpation.
Genitourinary - Hernia exam (Also, see cancer screening).
Lymph Nodes
The examination of organ systems must be supplemented with an evaluation of lymph nodes in the
cervical, auxiliary, and inguinal regions.
Neurological
The neurologic exam for uniformed personnel must include a general mental status evaluation and
general assessment of the major cranial /peripheral nerves (motor, sensory, reflexes).
Includes: Total Cholesterol, Low Density Lipoprotein (LDL -C) level, High
Density Lipoprotein (HDL -C) level and Total Cholesterol /HDL Ratio Glucose
Musculoskeletal Includes an overall assessment of range of motion (ROM) of all joints.
Additionally, observation of the personnel performing certain standard office services or functions is
helpful in assessing joint mobility and function.
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Blood Analysis $ 77.00
The following are components of the blood analysis. At a minimum, laboratory services must
provide these components in their automated chemistry panel (aka SMAC 20) and complete blood
count (CBC) protocols.
C - reactive protein
White Blood Cell Count
Differential
Red Blood CeII Count (Hematocrit)
Platelet Count
Liver Function Tests
Includes SGOT /AST, SGPT /ALT, LDH, Alkaline Phosphatase, and Bilirubin
Triglycerides
Cholesterol
HbA1c
Blood Urea Nitrogen
Creatinine
Sodium
Potassium
Carbon Dioxide
Total Protein
Albumin
Calcium
Urinalysis $ 16.00
Dip Stick
Includes pH, Glucose, Ketones, Protein, Blood, and Bilirubin
Vision Tests $ 32.00
Assessment of vision must include evaluation of distance, near, peripheral, and color vision.
Evaluate for common visual disorders.
Pulmonary (Spirogram) $ 38.00
Chest X -Ray $ 66.00
Stress EKG with Vo2 value calculated $ 235.00/$55
Oncology Screening Elements
Prostate Specific Antigen (PSA) $ 18.00
Fecal Occult Blood Testing $ 0.00
Skin Exam $ Included w/ Physical
individual Cost for Listed Items:
1 -100 exams $ 326.00
101 -350 exams $ 326.00
350 -700 exams $ 326.00
700 -1050 exams $ 326.00
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Physical Only
Physical with EKG
Physical with Stress Test
Physical with Stress Test and VO2 $ 561.00
Per Individual Cost for Listed Items Additional Screening Cost:
Price quotations for these additional screenings, based on need or at the request of the patient, may
also be provided during the basic exam.
Digital Rectal Exam
Testicular Exam
Clinical Breast Examination
Pap Smear
Immunizations and Infectious Disease Screening
Tuberculosis Screen (Annual PPD)
Hepatitis A Vaccine
Hepatitis C Virus Screen
Hepatitis B Virus Vaccine
Tetanus /Diphtheria Vaccine (Booster)
Measles, Mumps, Rubella Vaccine (MMR)
Measles Vaccine
Mumps Vaccine
Rubella Vaccine
Polio Vaccine
Varicella Vaccine
Influenza Vaccine
HIV Screening (Required to be offered)
Heavy Metal and Special Exposure Screening
Arsenic (urine)
Mercury (urine)
Lead (urine)
Lead (blood)
Aluminum
Antimony
Bismuth
$ 326.00
$ 381.00
$ 551.00
$ Included w/ Phvsical
$ Included wl Physical
$ Included w/ Phvsical
$ 42.00
$ 19.00
$ 64.00
$ 39.00
$ 56.00
$ 40.00
$45.00
$ Same as MMR
$ Same as MMR
$ Same as MMR
$ 35.00
$ 75.00
$ 30.00
$ 34.00
$ Included
$ 98.00
$ Included
$ 24.00
$ 18.00
$ 39.00
$ 38.00
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I•
Cadmium $ 31.00
Chromium $ 31.00
Copper $ 29.00
Nickel $ 31.00
Zinc $ 27.00
Organophosphates $ 65.00
(RBC cholinesterase)
Polychlorinated Biphenyls (blood) $ 108.00
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April 17, 2012
Chief Chris James
Fire Department
3117 Deans Bridge Road
Augusta, GA 30906
Dear Chris:
The Augusta - Richmond County Commission, at their regular meeting held on Tuesday, April 17, 2012 approved with
clarification on language to read awarded bid 12 -116 to University Health System as the vendor for Baseline Annual
& Pre - Employment Medical Exams for the Augusta, GA Fire Department. (Approved by Public Safety Committee
April 9, 2012)
If you ve any questions, please contact me.
Yours t ui ,
Tameka Allen
Deputy Administrator
04- 17 -12: #18
cc: Ms. Donna Williams
Ms. Geri Sams
Office of the Administrator
Frederick L Russell, Administrator
Tameka Allen, Deputy Administrator
William P. Shanahan, Deputy Administrator
Room 801 - Municipal Building
530 Greene Street- AUGUSTA, GA. 30901
(706) 821 -2400 - FAX (706) 821 -2819
www.augustaga.gov