HomeMy WebLinkAboutmedical protocolCity of Miami, Florida
Fire -Rescue Physical Examination Services RFP 03-04-080
Attachment A
MEDICAL PROTOCOL
(Annual and Hazardous Material, DIVE TEAM, AND TRT Physicals -
Department of Fire Rescue)
I. PHYSICAL EXAMINATION COMPONENTS
Medical History - Provider shall obtain a complete and
thorough medical history on the employee.
Provider must also perform a Health Risk Profile on the
employee. The purpose of this appraisal tool is to identify
a person's major health risks and how lifestyle habits
affect these risks. This confidential profile should
prioritize and explain the necessary life-style changes to
reduce risks.
Specifications: - The profile should have the following
characteristics:
1. Projects the relationship between chronological age
and risk age.
2. The profile will clearly and concisely show
participants both immediate and long-term effects
of their life-styles.
3. The profile used will be one that can derive a
management report identifying the relationship
between health risks and costs to the organization.
NOTES: The Health Risk Questionnaire will be filled out on the
first visit and will be reviewed during employee -
physician consultation.
Physical Examination (By Board Certified Physician)
Physical Examination DONE BY INSPECTION, PALPATION,
PERCUSSION AND AUSCULTATION to include the following:
General appearance
Height
Weight
Head, Scalp, face
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, City of Miami, Florida
Fire -Rescue Physical Examination Services RFP 03-04-080
Neck (THYROID, LYMPS, VESSELS)
Ears (INTERNAL AND EXTERNAL CANALS AND CERUMEN)
EAR DRUMS (PERFORATION)
Nose (SINUSES)
Throat (CONDITION OF TONSILS)
Mouth (TONGUE, TEETH, AND GUMS)
Spine (OTHER MUSCULOSKETAL)
Skin (SCARS, RASHES) LYMPHATICS
Upper extremities (STRENGTH, RANGE OF MOTION)
Lower extremities (STRENGTH, RANGE OF MOTION)
Lungs, chest wall, breasts (PHYSICIAN WILL OFFER TO
PERFORM BREAST EXAMINATION), back
Vascular System (VARICOSITIES, ETC.)
Heart (thrust, size, rhythm, sounds)
Endocrine system
Vital signs, T,P,R, (B/P both arms)
Neurological evaluation
Mental Status, memory, orientation, judgment,
intellect, affect
Abdomen, Viscera (check for hernias) -EVALUATION BY
INSPECTION, PALPATION, PERCUSSION & AUSCULTATION)
External Genitalia - EVALUATION BY INSPECTION,
PALPATION, PERCUSSION & AUSCULTATION)
ANUS AND RECTUM - DIGITAL RECTAL EXAM (OPTIONAL) FOR
EXAMINATION OF PROSTATE IN MEN AND TO CHECK FOR THE
EXITENCE OF OCCULT BLOOD IN BOTH MEN AND WOMEN,
Laboratory Work -up
1. Hematology panel
Complete Blood Count (CBC) with differential
2. Biochemistry Profile 25 and Complete Lipid Profile
With ratios and TSH (Thyroid)
3. Urinalysis (Microscopic)
Opthalmological Evaluation
1. Visual Acuity -- Both corrected and uncorrected
vision should be tested and recorded.
Note: A monthly report should be forwarded to
the Department of Employee Relations,
listing employees that do not meet the
following vision requirements: 20/40 one
eye and 20/100 other eye, uncorrected;
20/20 one eye and 20/40 in the other eye,
corrected. It should also be noted if
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City of Miami, Florida
Fire -Rescue Physical Examination Services RFP 03-04-080
individual wears glasses or contact
lenses.
2. Physical Examination by Board Certified Physician
to include:
a) Pupils
b) Extra -ocular movement
c) Conjunctiva
d) Sclera
e) Fundoscopic examination
f) Color vision
Pulmonary Function Test
(Screening for obstructive and restrictive diseases)
1. Vital Capacity and FEV 1
Utilize a spirometer that measures function by
volume, not flow. Minimal reported information
should be FVC, FEV 1, FEV 1/FVC%, FEF25-75%, and
MW. All volumes should be reported in absolute
values (liters), as well as percentage of age,
sex, and adjusted normals.
2. Any firefighter who falls below 80% of the
standard norm as a result of test 1. (above),
shall have a Flow Volume Loop, and a Post
Bronchodialator study.
PPD Skin Test - Performed by Mantoux method (required).
Electrocardiogram
Twelve lead resting EKG. Report with mounted rhythm
strip included in medical chart.
Audiological Screening
Test normal hearing range, 500 to 2000 HERTZ, using high
quality equipment in a sound treated booth or room.
Alternatives for sound treated booth or room must be
reviewed and agreed upon by the City.
Note: Upon failure of an audiometric screening,
exceeding levels of 25 dB for frequencies 500, 1000 and
2000 Hz at one frequency in either ear, a comprehensive
evaluation will be conducted.
II. ADDITIONAL/OPTIONAL EXAMS
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, City of Miami, Florida
Fire -Rescue Physical Examination Services RFP 03-04-080
OPTIONAL
1. Speculum and bimanual examination, including Pap smear.
2. Mammogram (females over 35 years of age).
3. PSA
OFFERED TO ALL MALES. RECOMMENDED FOR MALE
FIREFIGHTERS AGE 40 AND OLDER; AND AFRICAN-AMERICAN
MALES 35 AND OLDER.
4. DIGITAL RECTAL (MALES AND FEMALES) AND PROSTATIC EXAM
(MALES ONLY). INCLUDING A STOOL HEMATEST FOR OCCULT
BLOOD.
5. Comprehensive Hearing Test
Comprehensive evaluation should be conducted by
licensed audiological personnel and should include the
following:
History
External otoscopic examination
Comprehensive audiometric examination
Impedance examination
Note: A monthly report should be forwarded to the
Department of Employee Relations, listing employees with
hearing acuity loss
of 25 decibels or more for the speech frequencies of 500,
100 and 2000 Hz (cycles) .
6. Cardiovascular Stress Test
A cardiovascular stress test shall be administered to fire
fighters with a positive history of cardiovascular disease,
in themselves or their family, and to all those 40 years of
age or older. When recommended by the examining physician,
the following additional tests may be performed:
Echocardiogram, Thallium Stress Test, Exercise Muga Stress Test
7. Hepatitis A and H Screening (HBSAB) - RECOMMENDED EVERY 3
YEARS
8. Pulmonary Function Test
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City °MMiami, Florida
Fire -Rescue Physical Examination Services RFP 03-04-080
a. Flow Volume Loop- Compare flow to lung volume,
providing a more sensitive indicator of early
small airway disease: i.e. asthma, bronchitis, and
emphysema.
b. Post Bronchodilatory Study (to include 15 min. SAN
Tx (Side Arm Nebulizing Treatment).
This test measures the
bronchodilation in
ventilatory patterns.
percentage of small
reversibility.
response of the lungs to
comparison to normal
This determines the
airway disease and its
9. Radiological Evaluation - RECOMMENDED EVERY 3 YEARS
Standard PA and Lateral Chest (posterior, anterior, and
lateral chest views).
10. Flexible Sigmoidoscopy - for firefighters 50 years and
over, or to be conducted upon recommendation of the
examining physician.
11. Colonoscopy - For firefighters 50 years and over, or to
be conducted upon recommendation of the examining
physician.
12. RPR
13. 24 Hour Halter Monitor
14. Flu shot
ADDITIONAL
1. Tetanus Toxoid
Individuals who have not previously been immunized shall
receive the standard initial three -dose regimen. Those who
have not received a booster within 10 years shall be so
immunized.
2. Hazardous Material Team Physical, DIVE TEAM, TRT
Basic physical, plus:
a) Bilirubin Direct and Total
b) Cholinesterase
c) Heavy Metal Screening Quantitative for Pb (Lead),
As (Arsenic), Hg (Mercury)
d) Tonometry
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City of Miami. Florida
Fire -Rescue Physical Examination Services RFP 03-04-080
HEPATITIS A AND B IMMUNIZATION PROTOCOL
Hepatitis A immunization protocol shall be conducted as follows:
- The first visit shall include a training module. This
visit shall be scheduled between 7:00 a.m. to 5:00 p.m.
Monday through Friday, excluding legal holidays.
After the training module, those individuals to be
immunized will be given the first dose of the Hepatitis A
vaccine (HavrixTM A Adult) followed by the second
injection six (6) months after the first. Hepatitis A
does not require a blood titer after vaccination. These
vaccinations will be by intramuscular injection. The
dosing schedule for Hepatitis A vaccination is (0 and 6
months) .
Hepatitis B immunization protocol shall be conducted as follows:
The first visit shall include a training module and
(HBSAB) titer. This visit shall be scheduled between 7:00
a.m. to 5:00 p.m. Monday through Friday.
After the training module, and the (HBSAB) titer if
applicable, those individuals to be immunized will be
given the synthetic vaccine (e.g. Recombivax HB or
Engerix HB). These vaccinations will be by intramuscular
injections.
The second visit will consist of the initial injection
followed by the second injection one (I) month after the
first, and the third injection, six (6) months after the
first. A (HBSAB) titer will be drawn 1-2 months after the
last injection.
- It is now recommended that those individuals who do not
develop positive HBSAB's after a primary series, repeat
the entire series.
Hepatitis A and B combination vaccine (Twinrix) - protocol shall
be conducted as follows:
The first visist shall include a training module. This
visit shall be scheduled between 7:00 a.m. to 5:00 p.m.,
Monday through Friday, excluding legal holidays.
After the training module, those individuals to be
immunized will be given the first dose of the synthetic
vaccine (Twinrix) followed by the second injection one (1)
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City of Miami, Florida
Fire -Rescue Physical Examination Services RFP 03-04-080
month after the first, and the third injection six (6)
months after the first. These vaccinations will be by
intramuscular injection. The dosing schedule for Hepatitis
A and B combination vaccinations is (0-1-and 6 months).
Covers the following employee classifications:
1) Fire (all sworn)
2) Others as designated
53
AUG-26-2004 03:10PM FROM -HEALTH EVALUATION AND EXERCISE CENTER +305266202T T-043 P.001/006 F-124
ATTACHMENT B
as Cobelo
f Miami
,r„r— tment of Human Resources
444 SW 2nd Avenue 7th Floor
Miami FL 33130
August 25sh, 2004
Dear Ana:
It was a pleasure meeting with you last Friday concerning the City of Miami contract pricing.
Based on our meeting 1 am able to confirm the following fee changes to the contracts listed
below.
RFP # 03-04-080 Fire Rescue Annual Physical Examination Services
Basic Physical
Cardio. Stress Test
Thallium Stress Test
Pulmonary Function
Testing
Post Bronch. Study
Colonoscopy
HazMVlat Physical
660 Unit Price $145.00
574 Unit Price $425.00
55 Unit Price $ 1000.00
60 Unit Price $ 120.00
60 Unit Price $165.00
8 Unit Price $ 3000.00
24 Unit Price $215.00
Renegotiated Unit Price
Renegotiated Unit Price
Renegotiated Unit Price
Renegotiated Unit Price
Renegotiated Unit Price
Renegotiated Unit Price
Renegotiated Unit Price
RFP # 03-04-081 Sworn Police Physical Examination Services
Basic Physical
Cardio. Stress Test
Thallium Stress Test
1200 Unit Price $ 145.00 Renegotiated Unit Price
175 Unit Price $425.00 Renegotiated Unit Price
25 Unit Price $1000.00 Renegotiated Unit Price
$130.00
$400.00
$950.00
$100.00
$135.00
$2000.00
$195.00
$130.00
$400.00
$950.00
Mercy Outpatient Center continues to look forward providing professional services for the City
of Miami. If 1 can be of further assistance, please feel free to call on me.
Reuben J. Camp `i , MSN, RN
Director,
Center for Health Promotion
AUG-25-2004 03:I0PM FROM -HEALTH EVALUATION AND EXERCISE CENTER +3052052027 T-043 P.002/005 F-124
ATTACHMENT B
Ciry of Miami, Florida Fire -Rescue Physical Fxuminarioa Services
6.7. PRICE PROPOSAL FORM
Annual Physicals — Fire;
Dcsciintirm
Fire Department Annual Physical Exam
1)
2)
Basic Physical
Additional/Optional Exam:
a) Speculum and Bi-Manual
Exam including Pap Smear
b) Mammogram
c) Comprehensive Hearing Test
d) Cardiovascular Stress Test
1) Echocardiogram
2) Thallium Stress
3) Exercise Muga Stress
e) Hepatitis A and B Screening
f) Tetanus Toxoid Immunization
g) Tetanus Booster
h) Pulmonary Function Test
1) Flow Volume Loop
2) Post Bronchcdilatory Study
i) Radiological Evaluation
J) Flexible Slgmaidoecopy
k) Colonoscopy
1) RPR
m) Hazardous Material Team Physical
n) 24 Hour Holter Monitor
o) Msritoux Test
p) Flu Shot
Est.
Quantity Unit Price
660 $.
$ 25.00
60
75 $ 175 , 00
660 $,
574
200 S
55 00
9 $ 5nn.no
330 $ n0
330 S-25„-0.0
1 $ 9 11Q
60 $ I. a
60 $.
100
9
8
1 $
24 $. 0
15 $ 0
1 $00
300 $
45
Subtotal
RFP 113.04.080
Extended
Price
g 9 00.00
$ 1500.00
$ 13125.00
$ 16500_00
21Pitre -00 �.� 4112‘14'oa3
$ 7gnc�n.o0 oISZ� -(521�)
S.9gn0 00
S 8,50.00
$ Ei,tO
$5375.00
reef :-00
$10.00
$500
s 5T25.00
s 10.00
$ 7500.00
0
100 -k,t42000,oc
165 — o•00
r2 QXD Ib 000 •e
55cl�JJ�.D
AUG-25-2004 03:20PM FRONT-HEALTN EVALUATION AND EXERCISE CENTER +3052052027 T-043 P,003/005 F-124
ATTACHMENT B
City of Miami, Florida
Fire -Rescue Physical &amisation Services RFP 03-04-080
HEPATITIS A and B IMMUNIZATIONS
Est. Extended
Description Quantity Unit Price Price
1. HEPATITIS A IMMUNIZATIONS
Iri accordance with Spccificadona
(a) First injection 75 $ 68.00 $ 5100.00
(b) Second injecrion 75 $ 68.00 $ 5100000
2. HEPATITIS B IMMUNIZATIONS
In accordance with Specifications
(a) First ittjcction 75 $, 60.00 $ 4500.00
(b) Second injection 75 S 60.00 $ 4500. 00
(c) Third injection 75 $ 60.00 $ 4500.00
3, HEPATITIS A AND B COMBINED (TWINRIX)
In accordance with Specifications
(a) First infection 75 $._,1QL4Q0 $ 67 50.00
(b) Second injection 75 $ 90.00 $ 6750.00
(c) Third injection 75 $ 90.00 $ 6750.00
(d) Please list any other charges associated
with fulfilling this RFP and describe below:
$
Subtotal $ 43950.00
TOTAL COST FOR FIRE -RESCUE ANNUAL PHYSICAL EXAMINATIONS
AND HEPATITIS A AND B IMMUNIZATIONS. SERVICES:
dbat Mercy Outpatient Center
Submitted by: Mercy Medical Develppmeat Dater t
Name of Proposer
Authorized Signatvr
Note: Quantities indicated herein are estimates and are subject to change.
n.00
c003 500.O0
Oy
• t1 _ 1 Y'_ ' ► • Ali i :► • I : 1
46
PR
ACCEPTANCE OF CITY MANAGER AND
EVALUATION COMMITTEE'S RECOMMENDATION
RFP NO. 03-04-080
ITEM: Physical Examination Services
DEPARTMENT: Employee Relations/Fire Rescue
TYPE: Contract
RECOMMENDATION:
It is recommended that Mercy Medical
Development d/b/a Mercy Outpatient Center to
provide Fire Rescue annual physical examination
services for designated personnel, for the
Department of Employee Relations; and further
authorizing the City Manager to negotiate and
execute a Professional Services Agreement, for a
period of two (2) years with the option to renew for two
(2) additional two (2) year periods, at an estimated
annual cost not to exceed $603,500, with increases not
to exceed 5% for each renewable period for an
estimated total contract amount of 83,862,520;
allocating funds therefore from the General
Operating Budget of the Department of Fire
Rescue, Account Code Nos.
001000.280401.6.260 and 001000.280601.6.260.
AwardlssueRFP