HomeMy WebLinkAboutResolutions - 1993.12.09 - 22367MISCELLANEOUS RESOLUTION #93275 December 9, 1993
BY: GENERAL GOVERNMENT COMMITTEE, DONALD W.JENSEN, CHAIRPERSON
IN RE: DEPARTMENT OF INSTITUTIONAL AND HUMAN SERVICES/MEDICAL CARE
FACILITY - CONTRACTING FOR MEDICAL SERVICES
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gentlemen:
WHEREAS care facility and medicaid regulations require
licensed physician services be provided to residents of the Medical
Care Facility; and
WHEREAS the Medical Care Facility currently has a full-time
physician on staff; and
WHEREAS the full-time physician has announced his intention to
retire under the early-out program; and
WHEREAS all other county medical care facilities in the state
contract for the required medical services; and
WHEREAS private physicians are willing to provide the required
services to the Oakland County Medical Care Facility in exchange
for permission to invoice directly for their services, at no cost
to the County; and
WHEREAS a physician, with extensive experience with this
specific population, has been identified and is willing to provide
the services as detailed in the attached document; and
WHEREAS a proposed amendment to the 1994-1995 County
Executive's Budget Recommendation has been introduced to the
Personnel and Finance Committees' budget hearings to delete the
full-time physician position and to contract these services to a
private physician, saving the County approximately $67,000
annually.
WHEREAS the physician with whom the County is anticipating
contracting with has indicated that he will secure and provide to
the County a policy of malpractice insurance providing a minimum
policy limit of $1,000,000 per claim.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board of
Commissioners approves the contracting of medical services for the
Medical Care Facility with the specific requirement that the
contracting physician or physicians provide a policy or policies of
malpractice insurance with a minimum policy limit of $1,000,000 per
claim, approved by the Oakland County Risk Manager, before the
contracting physician or physicians provide any services on behalf
of the County under the terms of this contract.
Chairperson, on behalf of the General Government Committee, I
move the adoption of the foregoing resolution.
GENERAL GOVERNMENT COMMITTEE
MCF
4-52100-163-30-00-3128
CBL
CONTRACT
COUNTY OF OAKLAND
DEPARTMENT OF MANAGEMENT AND BUDGET
Purchasing Division
Req. #031030 PSC #2701
PROFESSIONAL SERVICES CONTRACT
THIS AGREEMENT, made this 1st day of December, 1993, between
the COUNTY OF OAKLAND, a Michigan Constitutional Corporation,
hereinafter called "County", and DONALD S. DREYFUSS, M.D., 81
WHYSALL LANE, BLOOMFIELD HILLS, MI 48304, hereinafter called
"Contractor".
WITNESSETH:
For and in consideration of the mutual covenants and
agreements herein contained, it is agreed by and between the
parties hereto that the County shall retain Contractor as an
Independent Contractor, with the parties agreeing to the following
terms and conditions:
Scope of Work:
1. To provide physician services to the Oakland County
Medical Care Facility residents. The Physician shall be designated
as the "Medical Director" and is responsible for the overall
coordination of the medical care provided in Oakland County Medical
Care Facility, as stipulated in (483.75) F508, 1509, F510. As
Medical Director, Dr. Dreyfuss shall:
a. Ensure the adequacy and appropriateness of the
medical care services provided to the patients and;
b. Maintain surveillance of the health status of the
employees and;
.-.:. Perform all duties commensurate with an encompassed
by the title of Medical Director.
2. The Contractor shall submit to the County the following
documents:
a. A notarized copy of the medical diploma from -n
accredited (medical) school.
b. A copy of the current Michigan license to practice
either medicine or osteopathic meCcine and surgery.
C. A copy of the current Michigan Corr:olled Substance
License and current DEA registration.
d. The name of an alternate physician avaiWale in case
of an emergency.
e. A letter written by the physician (named as the
alternate) accepting such designation and the willingness to
provide the necessary medical direction. In addition, will provide
the following for all physicians named as alternate or associates:
1. A notarized copy of the medical diploma from
an accredited medical school.
2. A copy of the current Michigan license to
practice either medicine or osteopathic
medicine and surgery.
3. A copy of the current Michigan Controlled
Substance license and current DEA
registration.
3. The medical care of each resident must be under the
supervision of a physician. (483.40(a)(1) F386 and R325.20601(1)).
4. The physician shall examine the resident within forty-
eight (48) hours of admission. The only exception will be in the
case of a Friday admission in which instance the physician shall
examine a resident within seventy-two (72) hours of admission.
(R325.20602(1)).
5. The examination shall include a chest x-ray, unless a
chest x-ray has been taken within ninety (90) days of admission and
a report of the results (of the aforementioned x-ray) is available
at the time of the resident's admission for inclusion in the
resident's clinical record. (R325,20602(3)).
6. The physician shall prescribe a total program of care
based on a medical examination of the resident's immediate and long
range needs. The documentation required following such medical
examination of the resident (after admission) shall include a
clinical history and physical exmination, appropriate diagnosis,
and written orders. The afore- -ntioned documentation shall be a
permanent part of the resident's clinical record. (483.40(b)(1)
F388 and R325.20606(2)).
7. The physician shall personally visit and examine all
residents at least once every thirty (30) days. (More often if
required by resident's medical coverage),
8. The physician shall review and revise as necessary the
resident's total program of care (including medications and
treatments) at each visit required by paragraph 6 above.
(483.40(b)(1) F388).
9. The physician shall legibly write a progress note in the
resident's clinical record at the time of each visit. Such entry,
written by the physician, must include pertinent clinical
observations. (483.40(b)(2) F389 and R325.20603(1))-
The physician may dictate a progress note if the
information is of such length and volume as to lend itself to
dictation. However, the physician is still required to write a
progress note in the resident's clinical record which briefly
states pertinent information (contained in the dictated progress
note) at the time the physician visits and examines the resident.
This is necessary to ensure that information essential to resident
care is available to other health care professionals in a timely
fashion.
10. The physician shall personally visit and examine the
residents at the intervals stipulated in the above paragraph in
accordance with the schedule mutually agreed to by the
Administrator, the Director of Nursing Services, and the physician.
This schedule will allow other health care professionals to respond
in a timely and appropriate manner to any medication and/or
treatment order changes written by the physician.
Physician to visit and examine each weekday. The
physician may change/amend the list of residents scheduled to be
seen on a particular day, however, scheduling of future visits to
ensure compliance with documented visits at stipulated intervals
(every thirty (30) days from the date of admission) shall be the
sole responsibility of the physician.
11. The physician shall see any resident regardless of
scheduled visit date, if in the opinion of the nursing supervisor,
the resident's condition has changed and warrants physician
intervention.
12. The physician shall countersign all telephone and verbal
orders written in the resident's clinical record by the licensed
nurse within Iforty-eight (48) hours. (R325.20605(2)).
13. The physician shall fully inform the resident of his or
her medical condition unless medically contraindicated (as
documented, by the physician, in the resident's clinical record).
This duty cannot be delegated to another health care professional.
(483.10(b)(3) F157 and Section 20201(e) of the Public Health Code).
14. The physician shall provide continuous medical
supervision of substitute for the physician. (483.40(a)(2) F387).
15. Telephone orders will only be given by a licensed
physician.
16. Use of a signature stamp shall be prohibited in the
resident's clinical record. The physician may not sign blank or
incomplete records.
17. Nursing requirements to record the resident's weight,
temperature, pulse and respirations stipulated in the state rules,
are in conflict with the regulations which specify the time
interval between documented physician visits. Although convenient
for the physici, this nursing documentation may not, of necessity
(because of the difference in requirements), be available at the
time the physician examines the resident. The absence of such
information does not in any way relieve/delay the physician of his
responsibility to visit and examine the resident at the prescribed
intervals.
18. All orders for pharmacy items shall be filled and
dispensed from the Oakland County MCF Pharmacy.
19. All orders for lab work shall be completed by the OCHD
lab or outside lab contracted with by Oakland County.
20. The physician shall follow the MCF procedures when
notified regarding the death of a resident including completion of
the death certificate as appropr.
21. The physician shall nct engage or otherwise involve
himself in the duties, responsibilities, tasks, functions delegated
to the Administrator by the Governing Board.
22. If the physician is appointed as a member of a committee,
the physician shall attend the s, .fied committees.
a. The physician shal_ participate in our quality
improvement program as requested by the Administrator or Quality
Improvement Coordinator.
23. The physician shall pr_rform all pre-employment and
periodic physical examinations of the Facility's employees as
required. Such physical examinations are scheduled through the
Nursing Office.
24. The physician will complete the certification and
recertification, as required by either Medicare or Medicaid
regulations, in a timely fashion.
25. The Contractor shall coordinate with the contract
administrator of the Medical Care Facility.
NON-DISCRIMINATION
In connection with the performance of Work under this
contract, the Contractor agrees not to discriminate against any
employee or applicant for employment because of ,sex, race,
religion, color, national origin, or handicap. The aforesaid
provision shall include, but not be limited to the following:
recruitment or recruitment advertising; employment, upgrading,
demotion or transfer; layoff and selection for training, including
apprenticeship, in accordance with rules and regulations
promulgated by the Federal (Compliance Responsibility for Equal
Employment Opportunity -- Chapter 60, 60-1, 4, No. 1-7) and State
(Standards and Procedures for Executive Directive 1975-6, Section
II-C, IV-C, and V-A&B) agencies and related Federal and State laws
and regulations.
PAYMENT
The Physician will be responsible for billing third party
payers for medical care services provided. The clerical tasks
associated with the billing for physician services shall be the
sole responsibility of the Physician. The Physician shall maintain
all necessary records to comply with the various third party payers
reimbursement regulations.
Further, the Physician agrees to accept as "payment in
full" for medical care services provided the fees established and
paid by the third party payor (i.e., Medicare, Medicaid, BC/BS, or
Hmo's/PPo's). No attempt will be made by the Physician or any
agent, employee or contracted service of said Physician to obtain
any additional compensation from the patient, the patient's
guardian, the patient's family, the patient's designated
representative, the patient's name responsible party or Oakland
County.
Further, the Physician agrees to accept a fee structure
established by Michigan Blue Cross/Blue Shield when calculating the
designated "private pay" patients' physician serv2,ces bill.
Further, the Physician agrees to assume the
responsibility for any uncollected or uncollectible fees.
Further, the Physician shall use his own provider number.
OFFICE SUPPORT
The County will provide the Physician with office space,
equipment and supplies necessary to perform the duties and
responsibilities. All other documentation required as part of the
medical care of the patient will be the responsibility of the
Physician, e.g., progress notes, etc.
ACCESS TO BOOKS AND RECORDS
The books, records and documents of the Physician
pertaining to this Agreement shall be made accessible, upon written
notice, for inspection by the Comptroller General of the United
State, the Secretary of Health and Human Services and their
authorized representatives until the expiration of four (4) years
after the services hereunder are furnished.
The County has the right, as its option, to terminate
this agreement, upon thirty days written notice, in the event the
Contractor defaults in the performance of the agreement, or
breaches any term of this agreement. The County's obligation in
the event of termination is for payment for actual services
rendered until the Contractor is notified of termination, or for
services actually rendered during the period of notice after notice
is served. In the event of termination, the County is not
obligated for payment for the duration of the term of the agreement
unless such term is less than 30 days at the time notice of
termination is given.
The Contractor has the right, as its option, to terminate
this agreement by giving written notice to the County in the event
the County defaults in the performance of the agreement, or
breaches any term of this agreement. A default in performance
and/or breach of this agreement shall include, but is not limited
to the following: (1) failure to cure a default in payment within
30 days after Contractor provided written notification of default.
IT IS MUTUALLY AGREED AND UNDERSTOOD:
1. The Contractor has represented to the County the
following facts as an inducement to enter into this agreement and
declares such statements to be true:
- Contractor warrants that all services performed
hereunder will be performed in a manner that
complies with all statutes, regulations,
ordinances, professional standards applicable to
the services provided;
- The Contractor pays, and will continue to pay, its
own local, state and federal taxes, including
without limitation, social security taxes, and
unemployment compensation taxes, and will file its
own annual and/or quarterly tax returns with the
proper federal, state and local authorities;
- The Contractor will provide and maintain its own
worker's compensation insurance, general liability
insurance, automobile insurance as required by the
State of Michigan;
- The Contractor shall take out and maintain during
the life of the Contract such Public Liability and
Property Damage Insurance (construed as including
contractor's Contingent or Protective Insurance to
protect the contractor from damage claims arising
from operations under the contract) as shall
protect him from claims for damages for personal
injury including accidental death, as well as from
claims for property damages which may arise from
operations under the Contract whether such
operations by himself or by any subcontractor or by
anyone directly or indirectly employed by either of
them. The amounts of such insurance shall be as
follows:
a. Liability insurance for Comprehensive
General Liability is to include coverage for
Personal Injury in the minimum amount of
$300,000 Combined Single Limit per occurrence.
Medical Malpractice Insurance in the minimum
amount of $1,000,000 per claim and errors and
omissions in the amount of S100,000/claim and
$300,000 aggregate
- The Contractor maintains and will continue to
maintain all applicable business and professional
licenses necessary to provide the services
contracted for;
- That Contractor maintains a business office at the
address listed above;
- That the Contractor will not seek employment as an
employee of the County during the term of the
contract;
- That the Contractor has undertaken a significant
investment in its business and in the good will of
its enterprise;
- That nothing in this agreement is intended to
establish an employer-employee relationship with
the County.
2. That the Contractor's relationship to the County is that
of an Independent Contractor. This Contract shall not cause the
County to be liable for, or Contractor to accrue, benefits such as,
but not limited to, Worker's Compensation, retirement, pension,
vacation pay, sick pay, merit increases, annual leave
days, promotion, disability pay, insurance of any kind, or any
other rights or liabilities arising out of a contract of hire or
employer-employee relationship.
3. The Contractor shall indemnify and hold the County
harmless from any and all actions, liabilities, claims, loss and
damage (including costs of litigation and actual attorney fees)
alleged to have been caused by, or to have arisen, directly or
indirectly, from the acts, performances, negligence, malpractice,
errors or omissions of the Contractor or the Contractor's
assistants, employees or agents, including without limitation, all
claims relating to injury or death of any person or damages to any
property.
4. Pursuant to the provision of Public Act 317 or 1968, as
amended (MCL 15.321, et seq.), no contracts shall be entered into
between the County Including All agencies and departments thereof,
and any employee or officer of the County. To avoid any real or
perceived conflict or interest, the Contractor shall identify any
relative or relative of the Contractor's employees and
subcontractor who are presently employed by the County. Nothing
contained in this provision limits or is intended to limit in any
way the Contractor's right to offer and provide its services to the
general public or other business entities, municipalities or
governmental agencies, during or after the term of this agreement,
or from working for more than one rim, entity or agency during the
term of this agreement. The Contractor may provide services to
others during the periods when the Contractor is not engaged in
performing services for the County. This agreement is a non-
exclusive agreement, and the County may engage other independent
contractors to perform the same work which the Contractor performs.
5. This contract does not authorize any in-kind services
unless previously agreed by the County and specifically listed
herein.
6. The Contractor shall allow the County's Auditing division
to perform financial and compliance audits as appropriate with the
authority to access all pertiflr1 records and interview any of the
Contractor's employees througher, the term of the Contract and for
a period of three years after final payment to ensure a complete
post-evaluation of services.
7. The Contractor is responsible for providing equipment and
supplies not otherwise provided by the County.
8. The Contractor shall have the right and duty to exercise
control and supervision over the immediate job site and work area
where the Contractor's services are rendered to the extent
necessary to accomplish the job specifications/services set forth
in this Agreement.
9. In the event the Contractor is unable to perform the job
specifications/tasks as required under this Agreement at the time
(or for any period of time) in which performance is due, the
Contractor remains solely responsible for continued performance
which includes, but is not limited to, the retention of an
assistant to substitute for and complete the Contractor's services.
The Contractor must notify the contract administrator in the event
Contractor is unable to perform such services when due.
Any and all assistants employed by the Contractor are
employed at the Contractor's own expense (including taxes and
insurance) and the Contractor remains solely responsible for and
fully liable for the conduct and supervision of any assistant it
employs. Contractor warrants that any services performed by
Contractor's assistants shall fully comply with the terms of this
agreement and shall be of the same quality of service as Contractor
has customarily provided to the County. All assistants employed by
the Contractor shall be deemed employees of the Contractor and not
employees, agents or sub-contractors of the County.
10. The Contractor shall be responsible and liable for all
costs and expenses incident to the performance of services for the
County including, but not limited to professional dues, association
fees, license fees, fines and penalties. The County shall not be
liable for any expenses incurrea by the Contractor in performing
services for the County.
11. While the Contractor retains the right to perform
services at any time, any services which require access to County
facilities may only be Performed during the County's regular
business hours.
12. This Contract shall become effective on the day and date
first above written, and shall terminate on the 30th day of
November, 1994. The Contractor is not guaranteed any right or
preference to a continuation of this Contract. The County of
Oakland, however, reserves an option to extend the expiration of
this agreement, contingent upon consent of the Contractor, up to
two additional years.
IN WITNESS WHEREOF, the parties hereto have executed this
Agreement on the respective dates hereunder indicated.
COUNTY OF OAKLAND, a
Michigan Constitutional
Corporation
WITNESS Oakland County Purchasing
WITNESS
(Date)
Contract Administrator
(Date)
Individual Contractor
(Federal Tax I.D./S.S.
(Date)
lmg
Rev. 10/93
Rcoolution #93275 December 9, 1993
Moved by Jensen supported by Aaron the resolution be adopted.
AYES: Douglas, Garfield, Gosling, Huntoon, Jensen, Johnson, Kaczmar,
Kingzett, Law, McCulloch, Miltner, Moffitt, Oaks, Obrecht, Palmer, Pernick,
Powers, Price, Schmid, Taub, Aaron, Crake, Dingeldey. (23)
NAYS: McPherson. (1)
A sufficient majority having voted therefor, the resolution was adopted.
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lynn D. Allen, Clerk of the County of Oakland, do hereby certify that the
foregoing resolution is a true and accurate copy of a resolution adopted by the
Oakland County Board of Commissioners on December 9th., 1993 with the original
record thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the
County of Oakland at Pontiac, Michigan this 9th. day of December, 1993
Lynm D. Allen, County Clerk