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HomeMy WebLinkAboutBid Response - Life Scan Wellness CentersRFP RESPONSE: POLK COUNTY Request for Proposal Title: ANNUAL FIREFIGHTER PHYSICALS RFP #13-407 Due Date: Wednesday, June 26, 2013 2:00 p.m. EST LIFE EXTENSION CLINICS, INC. dba: Life Scan Wellness Centers 1011 North Macdill Avenue Tampa, Florida 33607 (813)876-0625 Patricia Johnson, CEO TAB 1: Letter of Transmittal TAB 2: Personnel Requirements TAB 3: Reporting Capabilities TAB 4: Mobile Testing TAB 5: Comprehensive Safety and Security Program TAB 6: Cost TAB 7: Subco tractors (Attachment B) TAB g: Medical Laboratory TAB 9: Proof Of Insurance TAB 10: Additionalllnfortion Polk County RFP 13-407 Annual Purefighter Physii TAB 1: LETTER OF TRANSMITTAL Legal Name: DBA: Corporate Address: Testing Site: Phone Number: Authorized Representative: Email: Incorporated: Medical Director: Medical License: To: Re: Solicitation#: Due Date: Receipt of Addendums: Life Scan acknowledges receipt of Addendum #1: June 14, 2013 Life Scan acknowledges receipt of Addendum #2: June 19, 2013 Life Scan acknowledges receipt of Addendum #3: June 24, 2013 Letter of Transmittal: As the founder and CEO of Life Scan Wellness Centers, I am pleased to present this response to your request for proposal for RFP-13-407 "Annual Firefighter Physicals" and, if selected, agree to provide the proposed Project Services according to the Scope of. Services: Life Scan proposes to provide an on -site program at a location designated by Polk County with the option to utilize any of our other Life Scan Centers as needed. An on -site program can help to ensure an expedient time frame for services as well as provides an option to keep employees on -duty resultingin a reduction in costs, time away from the job, or even overtime. Life ExtensionClinics, Inc. Life Scan Wellness Centers 1011 N. Macdill Avenue Tampa, FL 33607 On -site at locations) determined by POLK COUNTY Phone: (813) 876-0625 Fax: (813) 876-0653 Patricia Johnson, CEO lifescanhc@aol.com Florida, August 1998 Anthony L. Capasso, M.D., P.A. FL ME69518 Polk County Request for Proposal: Annual Firefighter Physicals RFP-13-407 June 26, 2013 at 2:00 PM Local Time Life Scan's background is in the area of professional medical services for public safety departments with fifteen years' experience in the development and '• implementation of programs for state, municipalities and counties to fit their specific needs. We have recognized the vital importance of combining the key components of health, wellness, and fitness to generate the healthiest, most productive employees. Life Scan specializes in providing government agencies with public safety physical exams that comply with NFPA 1582, the IAFF/IAFC Wellness Fitness Initiative, OSHA, and FDLE as well as incorporating an advanced level of medical assessments for the early detection of cancer, cardiovascular diseases, and other potentially catastrophic illnesses. Our Life Scan model of "ultrasound -aided physical exams" for Public Safety Officers has been incorporated into the medical standards for over 150 fire service and law enforcement departments. £ As a result, we have the proven ability to identify cardiovascular disease, aneurysms, diabetes, and cancer more accurately and in much earlier stages in the disease process resulting in a substantial, long-term disability, absenteeism, and health care cost savings to the employer and the potential for lives saved. Polk County RFP 13407 Annual Firefighter Physicals Experts consider public safety to be among the most stressful and hazardous of all professions with long- term exposure to toxic materials and infectious disease, high levels of physical demands, frequent spontaneous fluctuations in, blood pressure resulting from the "fight to flight" response, exposure to emotionally devastating events, and the effects of shift work. Studies confirm that the average firefighter and officer have almost three times the incident of heart disease, lung disease, and cancer and dies an average of 12 years before other public employees. With the ever-increasing occupational medical risks, counties and cities must look towards new methods of prevention and intervention to protect the health and ensure the longevity of their most valuable assets.,.their employees. Most public safety personnel are aware of the importance of, being physically fit, yet many have undetected medical issues or lack the endurance and strength to efficiently perform their jobs, putting themselves, their peers, and citizens at risk. In professions as demanding and hazardous as firefighting and law enforcement, being medically, physically, and mentally fit will provide your employees with the capability to perform optimally, decrease stress and stress -related health and emotional problems, and, greatly reduce the incidence of work related illnesses and injuries. Life Scan has a distinctive approach to occupational medicine. The Life Scan public safety physical is an integrated medical approach to occupational exams that combines NFPA 1582, OSHA Respirator Medical and Mask Fit Testing, and FDLE physicals with early detection of the major, diseases such as heart disease, stroke, cancer, diabetes, and aneurysms before they reach a catastrophic level. It provides your employees with a thorough assessment of their health as well as recommendations for achieving and maintaining long-term health, appropriate intervention, behavioral modifications, and methods to reduce health risks. Each Life Scan physical exam follows state and federal guidelines with the added -value benefit of ultrasound imaging assessments of ithe internal organs and cardiovascular system, more extensive laboratory blood profiles, diet and nutritional analysis, and a state-of-the-art fitness evaluation. A personal wellness plan with these recommendations will be provided along with a copy of the medical and fitness assessments. The Life Scan Wellness Program also includes a comprehensive fitness evaluation based on NFPA 1583 and the WFI recommendations. Our clinical exercise physiologists have the expertise and experience to assess the physical fitness levels of each employee in relationship to their cardiovascular and overall health condition. Our physiologists will recommend fitness goals and customizing an exercise prescription as well as diet and nutritional improvements. Life Scan and our medical staffing are experienced and knowledgeable in all aspects of the scope of services. As an on -going program of Health, Wellness, and Fitness, Life Scan will continue to be your team dedicated to identifying areas of concern, monitoring the recommended interventions and programs, and assuring that your employees attain and maintain the level of health and well-being that is crucial to perform their jobs optimally and greatly reduce.the chance for illness and injury. Thank you for the opportunity to respond to this RFP for Polk County Fire Rescue. Sin rely Patricia µohnson, CEO Polk County RFP 13-407 Annual Firefighter Physicals June 14, 2013 BOARD OF COUNTY COMMISSIONERS POLK COUNTY, FLORIDA ADDENDU AA #1 RFP .#13-407 ANNUAL FIREFIGHTER PHYSICALS This,addendum is Issued to clarify, add to, revise and/or delete items of the Contract Documents for this work. This Addendum is La pert of the Contract Documents and acknowledgment'of its receipt should be noted on the Addendum. Contained within this addendum: questions and answers received gntart l(dL 1 Polk County'ProbUreMent Director This Addendum sheet shou d,be signed and returned to the Procurem nt Division at 863-534-6789. This is the , niy acknowledgment required. s Signature; Printed Name: Title: Company: 41 ef/0/0.5. , Lc-04.m sead/iztg.5 Cril?err RFP�I[ #13.407 ANNUAL FIREFIGHTER PHYSICALS ,ADDEN'OUtw• #1 Question 1: Does Polk County require the knowing laboratory tests for Hazmat members: Heavy Metals arid/or Cholinests!ese? Answer. % No Questions 2: Would you accept bids without the ultrasound component? Perhaps this component can be part of a separate wellness initiative bid? Answer. No June 19, 2013 POLK COUNTY, FLORIDA ADDENDUM #2 RFC 1 3-40? ANNUAL FIREFIGHTER PHYSICALS This addendum is issued to clarify, add to, revise and/or delete items of the Contract Documents for this work. This Addendum is a part of the Contract Documents and acknowledgment of its receipt should be noted on the Addendum. Contained within this addendum: questions and answers received If there are any questions that relate=to the a..rrs given in this addendum only those may be submitted by Friday, Juno 21, 2013 by 12:00 noon. No further questions will be taken after that date and time, 41tt Polk County Procurement Director This Addendum sheet should be signed and returned to the Procurement Division at 863-534-6789. This is the only acknowledgment required. Signature: Printed Name: Title: Company: bittgg64WOri. 11-' cY/,nets 7)) RFP #13-407 ;ANNUAL FIREFIGHTER PHYSICALS ADDENDUM #2 Question 1: " Is this a new program, or ongoing? Answer. Utilizing an outside vendor is new. Question 2: If it is ongoing, who is the incumbent? Answer. Our own Wellness Center Question 3: What hos been the annual budget for this program? Answer Didn't have one Question 4: What services are being provided onsite at your project locations, and are any servicesperformed offsite at local provider locations? Answer: All services wilt be performed oisite Question 5: How many employees have been scheduled on a daily basis? Answer: 9 Question 6: Will you'consider the use of a mobile provider to provide all services on site, and in conjunction with a local providers throughout your service area to provide vaccines? Answer: Only if all is done onsite Question 7: What are the departments shift chedules (how many per shift, and time (hours) of. duty)? Answer. 3 twenty-four (24) hour shifts { Question 8: Can you' provide 15-20 firefighters per day for evaluations if we bring our staff and equipment directly to your project locations? Answer: 9 to 12 would be easier to schedule Question 9: Is blood sampling / analysis required prior to the medical evaluations, or can they be performed early morning the day of the medical evaluation? Answer: Early morning would work as low as results are available at the time of the medical evaluation Question 10: Can this,program , ,program be scheduled over consecutive days? Answer Yes but not for the same employees Question 11: Can this§program be performed pPt one central protect location? If no, how many site locations Would be required i'for set up of the program? Answer. No...S Question 12 Do you have fecilities at the testlsites that would support the performance of the physician's examination, and th ;fitness and ultra sound assessments? Please` note, alt other,exam elements v ouid be performed on our mobile unit slinultaneously at the project locations. Answer: Yes Question 13: Do all employees receive all components of the Cardiac assessment, page 7? Answer: Yes Question 14: How many males and females a(e in the department, and do they all receive the gender based ultra sound scree�hings? Answer: Of the approximately 300 exa Question 15: Do all males receive the PSA? Answer. Yes only about 25 will be female. Question 16: Do all females receive the CA-1 5? Answer. Yes Question 17: Will you ;consider alterative Tuberculosis screening (PPD or T-Spot) methods? Answer, No Question18: What Is the preferred method for Osteoporosis risk assessment (questionnaire and/or instrumentation)? Answer Both Question 19: Will all employees receive a fit test for both the SCBA and N-95 respirators? Answer: No...price separately Question 20; How does a vendor provide a cost per employee when some examination components are gender specific? I Answer: Average bid price base on male/female numbers provided in question 14. Question 21: Will the County accept an alternative bid proposal with fixed daily administrative, equipment and labor fees, and fixed itemized costs for each exam component? Answer: No, needs to be priced per exa I and be all inclusive other than additional priced components. l 1. Question 22: Will the vendor have the ability t submit additional questions after the County clarifies initial questions submitti ? Answer: Yes June 21, 2013 POLK COUNTY, FI-ORIDA ADDENDUM: #3 RFP #13-407 ANNUAL FIREFIGHTER PHYSICALS This addendum is issued toclarify, add to, revise and/or delete items of the Contract Documents for this work. This Addendum is a part of the Contract Documents and acknowledgment of Its receipt should be noted on the Addendum. Contained within this addendum: questions and answers received relative to Addendum #2 l . ri tau jitcaa lee Polk County' Procurement Director. This Addendum sheet should be signed and returned to the Procurement Division at 863-534-6789. This is the only acknowledgment required. Signature: Printed Name: Title: Company: 0.22,/ / 2 61;r4r Sl4)'1 1%.n ! C.5 /4ct RFP #13407 ANNUAL F!REF GHTER PHYSICALS ADDENDUM #3 Question 1: Does the Fire Department have a commercial treadmill available to the provider for the performance of the stress test? Answer. Yes Question 2: Can you provide the physical addresses of the 5 project locations? Answer. Not at this time, Question 5: Can you clarify the answer to q estion 10 In addendum 2, "Yes but not for the same employees? Answer. Each employee wit have his ph sical completed in one day. Not over a 2 day period. Question 4: Do all personnel receive the HI)1 C-diabetes screening? Answer Yes Question 5: Do all petrsonnel receive the oat Answer: Only for females. Question 6: What Hip C test is required? Answer: Antigen test porosis screening? TAB 2: PERSONNEL REQUIREMENTS Company Qualifications, a) Detailed Resume of Medical Director: See Attached a. Curriculum Vitae b. Florida License c. DEA Certificate Sonographers a. ARDResumMes b S Registry b c) Detailed Staffing Plan d) References Polk County RFP 13-407 Annual Firefighter Physicals TAB 2: PERSONNEL REQUIREMENTS; COMPANY'; QUALIFICATIONS -General Corporate: 1 Number of years in business 15 years Medical Director: Anthony Capasso, M.D, Number of years in practice l8 years Number of ;years as Medical Director for Life Scan: 9 years Life Scan'sspecialty andbackground is in a area of prevention -based occupational, medical services for goverrrnent agencies with a s ialty in public safety. We have over fourteen years experience in the - development and imple ntation of programs for county, and state public. safety departments to fit their specific nee We have recognized the vital importance of combining the key components of health, llness, and fitness to produce the healthiest, most productive employees. After researching an developing a program that is° specifically designed to meet the needs of public safety, we open our first on -site. wellness center m 2001 for the" City of Jacksonville; Since' then we have o ned three Life Scan Wellness Centers (only open to contracted government clients) and offer oni-site services to over 150 government agencies in Florida and the Southeastern states. The LillScan program provides annual fit for duty and post offer exams, respiratory protection programvaccines, and general employee exams at the same time integrating a model of early detection and prevention. Life Scan is currently providing the following services to over 150 County, and Municipal, and State government agencies: • NFPA.1582 Physical for Police and Firefighters • N_ FPA 1583 Fitness r Police and Firefighters • Fol., AFC Health d Wellness_Initiative • FDLE Police Physicals • DOT andCDL Physials • Hazinat Physicals • sWAT Team Physicals • Bomb Squad Physicals • Pre Employment Public Safety Physicals • OSHA Respirator. Physicals, • OSHA Respirator Mask Fit Testing ▪ Fit for'Duty Testing is • Oa -site Program for all medical testing • On -site X-ray services • On -site blood draws a • Infectious Disease to Ling and vaccines • Added value services including the Life Scan ultrasound -aided physical exams that complein nt to Public Safety Physical Examinations Polk County RFP 13-407 Annual Firefighter Physicals Life Scan Professional Contributions to Public Safety Health: In recognition of their outstanding accomplishments and understanding unique of the needs of fire fighters and law enforcement officers, Patricia Johnson and Tammy Torres, on behalf of Life Scan Wellness Centers, were appointed the edical Advisors to the • Major CitiesChiefs' Association • National Sheriff's Association • FBI LEEDA • FBI National Executive Institute Life Scan provides Firefighter Educational S ' friars, CEU courses, and professional articles to: • Florida Fire • Florida Professional Firefighters • Fire Rescue' International • International' Firefighter Smoke Sym siums • Florida Firefighter; Safety and Health onfcrences • Florida Cancer Survivor Network Polk County RFP 13-407 Annual Firefighter Physicals. PRINCIPALS, MANAGEMENT, AND PHYSICIAN SUPERVISORY TEAM: Patricia Johnson, CEO. Patricia is the cofounder of Life Scan and will be the liaison between the City and Life Scan. "Patricia will ovens a contractual issues, ensure proper invoicing, and attend meetings. Michael Terrana, CFO. Michael is an attorney in Tampa and started his law career as an assistant state attorney in',Hillsborough:County. He now is the lead partner of a firm that focuses on insurance defense and property law. Michael is the co-founder of Life Scan and serves as corporate counsel and Chief Financial Office Tammy Torres, DIM is ,the Life Scan Wellness Center Clinical Director and Project Manager. She is responsible for thelsupervision of the edical specialists and for the continuing education as well as medical procedures and protocol for the Life Scan Wellness Center medical program. Tammy will ensure quality control over me " ical reporting and records and manage scheduling timelines. She` is. also trained in all modalities of medical ultrasound and our advanced medical testing. Tammy has developed the . medicalprotocol forthe ultrasound -aided physical exam program and has extensive experience with NFPA 1582 guidelines and interpretation. Medical Director:,,Anthony" Capasso, M.D. Dr. Capasso has over 18 years in private medical practice. He is fully experienced in worke '' compensation, post offer employment physicals, firefighter and police ,physicals and indiced clearance, HAZMAT' medical . clearance, occupational medicine, arid internal medicine. Dr. Capasso is the supervisory medical director and advises with"medical clearance review. Life Scan is a nationally ,` recognized cxp and educator regarding the health and fitness of police and firefighters Life Scan has advised NFPA 1582 and the IAFF/IAFC Wellness Fitness Initiative Committees regarding firefighter health and fitness. Polk County RFP 13-407 Annual Firefighter Physical Section b) Medical Director CV and Licenses CURRICULUM VITAE ANTHONY L. CAPASSO, M,D. Florida Medical License: ME69518 EDUCATION 1984-1987 1984-1986 Ohio State!Univeirsity, Colurnbus, Ohio. Bachelor of Science --Biology Curia Laurie. Cleveland State University, Cleveland, Ohio. POST GRADUATE TRAINING 1988-1990 Ohio State College of Medicine, Columbus, Ohio 1991-1993 Universityof Alabama Schoo = of Medicine, Birmingham Alabama, M.D. May 1993.' 1993-1994 University!of Florida health eience Center, Jacksonville Florida; Internal Medicine I ternship. 1994 Universitylof Hawaii Integrated Medical Residency Honolulu, Hawaii; Internal Medicine Residency 7/1/94 -12/4/94 1995-1996 Universitylof Florida Health Science Center, Jacksonville Florida; Internal Medicine Residency. Graduation July 1996 HONORS AND AWARDS 1984-1987 Dsean's List every quarter. 9 1985 Sunima Award, University College, Ohio State University. 1987 Graduate Gum Laurie, Co11eg of Arts and Sciences, Ohio Stale University. 1989 MorioraryLetter from the Department of Anatomy for outstanding performance, Ohio Statc College of Medicine. CERTIFICATION Diplomat of the National Board of Medical Examiners, June 1993 Diplomat ABIM, August 1998 L!CENSURE State of Florida ME 0069518 MEMBERSHIPS 1984-1987 National Key Honor Society, Ohio State University 1988-93 American Medical Student's Association 1991-93 Tuscaloosa County Medical Association 1991-93. Larry Mayes Society 1993-1997 American Medical Association 1994-1997 ACP Member 1999-present Duval County Medical Society EMPLOYMENT 12/07-present 3/03-Present 9/07-Present 7/02-present 2/01- 2/03 8/99-12/00 4/98-7/99 5/97-4/98 7/96-4/97 12/96-4/98 Life Scan Wellness Centers -Medical Director Hospice of Jacksonville Associate Medical Director Smart for Life Jacksonville -Medical director Anthony L Capasso MViD. P.A.-private practice University Of Florida ` Clinical Assistant Professor Pre ruier Family Care - Internal Medicine Jacksonville Emergency Consultants - Emergency Medicine Premier Family Care i Local' Tenum South Beaches Medi Internal Medicine Barren Venus M:D.P CCU intensivist 1 AC#4642271 t DIVISION 0F*If The II• CAL 0007OR ' rnam� 0010,0r t m®t allre rem CAPASSO; ANTHONY,L MD351 3TH AVENUE SOUTH' SUITE 110 JACKSONVILLE BEACH, FL 32250-0000 DEA REGIBTRATIQN THIS REiISYRATION NUMBER:... EXPIRES£ BC4934483 08-3120`14 CONTROLLED SUBSTANCE REGISTRATION CERTIFICATE UNITED STATES DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION WASHINGTON D.C.. 20537 Sedan 304 and 1008 (7t USC 824 and 858) of the Canaolled Saatataaes Act of:;970 asamended, provida that the Attorney dl���yyjmay revoke'ar suspend a reglatradon• to-menutacture, bGba, dlspeneo; lmpat or export a conlralled eubstantie, . 1 Ht1; CERTIFICATE 8 NOT.tilAMSFERADI.EON CHANGE OF OWNERSHIP, CONTROL, LOCATION, OR BUSIN8SS ACTMTY, AND IT 18 NOT VALID AFTER .THE EXP1FtAT1ON DATE • - 411111111•1d ONTROLLE D$UBSTANOE.REGISTRATION .CERTFICATE UNITED`STATE DEPARTMENT OF JUSTICE DRUG ENFORCEMENT ADMINISTRATION WAS INOTON D.C. 20537 SCHEDULES 2,2N, 3,3N,415, 'PRACTITIONER CAPASSO, ANTHONYL MD 1351:13TH" AVENUE`SOUTK SUITE 110 JACKSONVILLE BEACH, FL 32250-00p0 PAID ,I 18SUE DATE 07-07-2011 SectIons304And 1008 (21 USC 824 and FA) Of the Controlled: Substanoea Act of 1970, . u 'amended, provide that the_Atfomey .,General may revoke or• suspend a. tag *atlon to manutachire, distribute; dlepetis®, import er export a tontrolled substance. THIS CERTIFICATE IS NOT TRANSFERABLE ON CHANGE OF OWERSHIP, CONTROL, LOCATION, OR BUSINESS ACTIVITY; AND IT,18 NOT; VALID.AFTER T E EXPIRATION DATE a Section c)s Sonographers' ]Licenses sand Resumes ('ha`rfndte C BeTp . Gndrntinlotip'$. �ra:ua„ ThtvaiOtel/31.1V1 ID:.+►I!4!�d . ROMB(AH+ YN) RVT(VT) RDC8( ) AROM19 • R1 IM 91Rd E P$t O11 157073 40 1 r ,' 121311db1$ �, y*4O I,le4ana'crit`.; Chairlotie Boyd, R S Experience: t Diagnostic Medical Sonographer, Echovascular Sonographer Education: • Performed abdominal, gynecological, obstetrical, superficial, pediatric, cardiac and vascular diagnostic sonography exams Assisted physicians with special procedures including paracentesis, thoracentesis, and biopsy procedures 2. Vascular Sonographer, Diagnostic Medical Sonographer Created/started the Vascular: Lab for Vascular Surgeons and Interventional Radiologists. • Managed various issues within the vascular, lab i.e. patient volumes, day to day tasks, equipment issues. • Performed more than thirteen various types of advanced vascular studies and abdominal studies. Assisted physicians in various venous procedures, arteriogams, paracentesis, and biopsy procedures. Bachelor of Science in Radiologic Sciences, major in Diagnostic Medical Sonography 08/07-05/09 Medical College of Georgia Augusta, Ga • Abdominal, gynecological, superficial, obstetrical, echocardiography:and vascular sonography included in course of study • Clinical experience for five semesters in a wide variety of facilities including hospitals, imaging centers, and physician's offices Undergraduate classes: Mars Hill College o8/04-05/06 Athens Technical College ;08/ 06-0g/o7 Certifications: RVS SDMS BLS ACLS (2o09) Jennifer Goodfield BA, RDIVIS & Ri/wr Life Scan iN®(mesa Centen3 Tampa and Largo, FL ;' Ultrasonographerperforms comprehensive ultrasounds including echocardiography, abdominal, thyroid, carotid,°testicles, bladder,,pelvin and prostate to successfully identify early detection of pathologies. • Nerthside Hospital Saint Petersburg,L Ulrasound. S�upervrsor Cardiac and Vacular Surgical Ast3ociatott Clearwater, FL , RVT = ne*-itited a wide range of vascular studies; pre and post endarectomies, pre and post vascular bypass Venous and venous insu ciency ultrasounds. Allan vain ablation surgeries Gulfcoaut Ultrasound;Schooi Instructor Saint Petersburg, FL Instruct hands-on ultrasound techniques to physicians, sonographers and new students in the specialties of OBlgyn.abdominal and vascular exams. Mease Hotipitate PRN;Technlcal Pool Ultrasonographer _ Specialize in obatetncal, abdominal, pelvic, va tar flow Doppler studies (venous, arterial and abdominal .R: vassals) small pats, proetato, breast, interventionLl-and intra-operative examinations • •RayfrontMedical Canter Ultrasonographer Saint Petersburg, FL Intensive experience in a wide range ofspecialtias n a Level II Traurna/Teaching center, Instructing at all levels IndependentSonographor Ultrason'ographer;', agin Dr Shaman GYfd pelvic anvasd transval ultrasounds ions Dr Hakki Vascular Surgeon cular ultrasounds,, and vein ablat EDUCATION 6achok r of Ails uhlieroiti of South Florida= Tampa, FL • 1993 Ultrasound Diagnostic School Tampa, FL Certificate with honors ADDITIONAL INFORMATION Accomplished background in vascular, OBIGYN and abdomen. • Excellent communication skills and ability work Well with diverse groups or independently Instructor, Mentor, conducting seminars to new hires, students and physicians Christina L. Norris, RVT, ARDMS Professional; Experience: Ultrasonographer 10/2012 present Life Scan tallness Centers - rgo, FL Perform ultrasound studies an Police and Fire department employees for annual employee physicals. Exams'include Thyroids, Carotids, Echocardiograms, Abdominals, Prostate, Testicular, and Pelvic. Ultrasonographer Kettering Health Network Sycamore Hospital MI misburg, Ohio Perform Venous ultrasounds to include Abdomen, OB/GYN,'Small Parts, and Cardiovascular. Diagnostic Sonographer Vanderbilt Imaging Serveees,i Nashville,TN Performed. various; ultrasound exams to include Abdomen,OB/GYN, Small Parts; and" Vascular:_Extended vascular studies to include Renal Dopplers, Renal Transplants, Abdominal Doppler. Ultrasonographer Gateway Health Systems, Clarksville,TN Performed various ultrasoundexams to include A bdomen,OB/GYN, Small Parts, and Vascular. Mammographer k Premier Imaging Center Ctarrkaville,TN Responsible for all QC and QA Performed Mammography on patients and prepared films to be read by Radiologist.".Kept records of° allTechnologistand Radiologist credentials. Radiographer/Mammogreplier " Kettering Radiologist Imaging Center Dayton, OH General x rays, Flouroscopy IVP's and Mammography. Radiographer/Mammographer Dayton Medical Imaging Vandalic, OH General X rays Flouroscopy and IVP's.', Mm amography. Radiographer Children's Medical Center Dayton,OH General X ray's Flouroscopyand IVP's. Singe / C arm. Worked closely with infants,chiidren, and teens. Education: Sinclair Community -College. Dayton,Ohio1990-1994 Associates Degree in Applled Science_, In Radiologic Technology z Volunteer State CommunityYColiege Gallatin,Tn. 2003-2004 Certificate In Diagnostic Medical Sonography. : Credentials: RVT,''ARDMS Reem Regno; ARDMS Qualifications • ARDMS registered in specialties Abdomen and OB/GYN. • BLS certified"with the American Heart Association. • Four years exeperien"ce with patient" care. • Two years clinical experience In various local hospitals and clinics. • Registry eligible for` specialties Echoc rdiography, Vascular, and Neurosonology. Clinical Experience • AB, OB/GYN, SmallParts • - High Risk Perinatal'!Protocol • Paracentesis/Thoracentesis • Echocardiography, TEE • Vascular, PVR Education' Associates of Science in Diagnostic Medical Sonography Broward College, Coconut Creek FL. May 2012 Bachelor of Arts and Sciences in Psychology University of South! Florida, Tampa FL Dec 2005 c) Detailed Staffing Plan The Life Sean program is designed specifically for public safety and the entire medical staff has extensive knowledge and experience in providing firefighter and FDLE physicals. The medical staff works in teams and each of them is experienced in all aspects of the scope of services and the Life Scan program including NFPA 1582, NFPA 1583, FDLE, OSHA Respiratory Standard, the WFI Initiatives,; pre -employment, annual edical clearances and reporting processes. Staffing: •' The Life Scan Staffing will i elude three (3) Life Scan employees that` are fully trained and experienced in pu lie` safety Life Scan physicals using an integrated, teanapproach. • Each team Member is a direct mployce of Life Scan and has undergone extensive training with Life Scan to ly understand the technical, clinical, Life Scan procedures, and individual pr ocols of the assessments and medical clearances. All Life Scan medical staffing receives annual, recurrent training in areas such as ACLS certification, Public Safety Disease Risks, Diabetes, Hazmat testing, Infectious Diseases, Blood borne Pathogen and Safety: Protocols, Medical Reporting Updates, NFPA 1582 updates, Wellness Fitness Initiate program, and Life Scan clinical updates. Ultrasound Technician The Life Scan registered ultrasound techn.,cians are fully cross -trained' in all modalities of medical ultrasound and interpretation including vascular, heart, abdominal, and general ultrasound as well as receive extensive training in the Life Scan protocols and, patient education. The Life Scan ultrasound team provides a key component to the overall health assessments, early detection testing, and education of our patients. ACLS Certified Mid Level Practitioner (1'1 P, MSN, or PA) Life Scan Mid Level Practitioners perform the on -site, annual and.pre-employment physicals, clinical assessments; administer the infectious disease program, and medical clearances under the supervision of Dr Capasso Life Scan Mid -level' practitioners' have' extensive 'experience providing niedicalclearance, pre -placement employment physicals, fitness for duty, NFPA 1582 and FDLE,Medical examsthe WFI, and OSHA Respirator Medical Clearance; -Tbiey each have a thorough understanding of the unique heeds, physical requirements, and mental stress related to the profession of firefighter and corrections personnel. ACLS. Certified Polk County RFP 13-407 Annul Firefighter Physicals Clinical Exercise Physiologist The Life Scan clinical exercise physiolo ' is are experienced in clinical cardiac testing and. interpretation, lung capacity (pulmonary function) testing and interpretation, ` :firefighter and correctional officer litnesS evaluations, diet and nutrition, body composition, and all, aspects of NFPA 1582, NFPA,1583, FILE, and the WFI. All Life Scan .physiologists are trained and experienced in OSIIA Respirator Medical`: Testing and OSHA Mask Fit Testing protocol. ACLS Certified Polk County RFP 13-407 Annual Firefighter Physicals d) Three (3) References from other Governmental Agencies that have utilized Life Scan's similar services: 1. Brevard County Fire Rescue Contact: AssistantChiefLeslie Hoggj Phone: (321) 633-2056 Performance Period: 2012 to Present Service Provided: LIFE SCAN Program for Firefighters: • NFPA'1582 Annual Physicals for Firefighters • NFPA 1583 Fitness; Evaluation Firefighters IAFF/IAFC Health and Wellness Initiative Life Scan ultrasound and advanced medical assessments for disease detection and prevention Ramie and Specialty Team Physicals On site program for. all m ical testing, blood draws, and X-rays Infectious Disease testing d vaccines OSHA Respirator Physic s for Public Safety OSHA;Respirator Mask Fit Testing for Public Safety 2. St. Petersburg Fire Rescue and St. Petersburg Police Department Contact Fire Chief James Large Phone: (727) 893.7694 Performance Period 2008 to present Service Provided:'LIFE SCAN Progi • NFPA 1582 and FILE and Firefighters • NFPA 1583 Fitness Eval tion for Pollee and Firefighters • IAFF/IAFC Health and W llness Initiative Life Scan ultrasound and advanced medical assessments for disease detection and prevention Hazmat, Swat Team, and pecialty Team Physicals On siteprogram for all medical testing, blood draws, and X-rays Infectious Disease testing and vaccines OSHA Respirator Physicals for Public Safety • OSHA Respirator Mask Fit Testing for Public Safety 3. Largo"Fire Rescue;• Contact Assistant Chief Shelby Will Email: swil• is@largo.com Phone (727);235 8455 " Performance Period: 2006 to present Service Provided:: LIFE SCAN Progr • NFPA 1582 Annual Physi NFPA 1583 Fitness Evali Polk County RFP 13407 Annual Firefighter Physicals, for Police and Firefighters: ual Physicals and Post Offer Physicals for Police m for Firefighters: s for "Firefighters lion Firefighters • IAFF/IAFC Health and Wellness Initiative • Life Scan ultrasound and advanced medical assessments for disease detection and prevention • Hazmatand Specialty Tea Physicals • On -site program for all medical testing, blood draws, and X-rays • Infectious Disease testing and vaccines • OSHA Respirator Physicals for Public Safety • OSHA Respirator Mask Fit Testing for Public Safety Life Scan provides this service, to over 1 SP police, corrections, and fire departments in Cities and Counties in the Southeastern Uni ed States. Other references will be provided upon request. Polk County RFP 13407 Annual Firefighter Physicals i .k. TAB 3e REPORTING CAPABILITIES All Life Scan reports are customizable based on the individual needs and requirements of each department. Employees: Each employee will receive copies of his Life Scan examination and test results on the day of their Life Scan exam to include a summary form, lab results, EKG, exercise ta, ultrasound reports and images of abnormal studies, patient educational handouts, and personal wellness plan. I Polk County Fire Rescue: • PCFR will receive a`FI'T FOR DUTY exam report and results of Hepatitis Titers/Screenings within 14 days of the exams. • Final Evaluations will be reviewed and signed by a licensed Physician, NP, MSN, or PA. • PCFR will be notified by. phone within 24 hours for any employee that is found to be NOT FIT FOR DUTY. Reporting Samples include: • FIT FOR DUTY/OSHA. RESPIRATOR MEDICAL CLEARANCE • OSHA MASK. FIT` TESTING REPORT Life Scan will provide samples of patient chart forms and patient results upon request. Polk County RFP 13-407 Annual Firefighter Physicals IV PLOYEE MEDICAL QUALIFICATION AND OSHA RESPIRATOR CLEARANCE Exam Date: Job Title: Employer: Patient Name: Patient -ID#: EMPLOYEE MEDICAL QUALIFICATION: The examination of this employee must include a complete physicalphysteat examination at a level of specificity to deternine;`whether there is any:inedical or physiological reason that may impair the'employee's ability to perform the essential functions of his of her job,,DDisabilities, impairment, or limitations identified by the examination, which wou d prevent the employee from performing the essential functions Of the position, will be reported to their employer a reviewing medical personnel should note all abnormalities which might predispose the employee to injury orvation of the condition due to the nature of the: duties and tasks required oftheir job: The employee is: l7 MEDICALLY QUALJ IED o NOT MEDICALLY; QUALIFIED. Tb patient must be examined by a medical specialist for follow ,, up evaluation and final` clearance. RESPXRATOR-CLEAliIVGE: This rn el cal evaluation OSHA luation determines any limitations on respirator.use related to the medical condition of the employee, or relating to theworkplace conditions in which the respirator` will_ be used;: including whether or not the employee is medically able to use a respirator. The employee is CI : MEDICALLY QUALIFIED TO WEAK 'A RESPIRATOR. There are:no restrictions on respirator use related to the medical conditionpf the } nployee.` D NOT MEDICALi.Y QUALIFIED'TO' to rnake a final deteraiiiiatioa _for respira AR A RESPIRATOR. `A follow up examination is, n Medical PractYdoner Print Nance: Medical Practitioner Signpture: • 1011 North Mscdill Avenue Tamp FL 33607 Veliness Centers Employer: ii OSHA RESPIRATOR MASK FIT TEST Patient Name: Exam Date: Patient ID#: Mask Fit Test (For Clinical Use Oi Iv) Job Title: Respirator Medical Clearance: 0 Pas . 0 Fail Date of Medical Clearance: Vision Correction Required: 0 Yes No If yes, What type correction used when Baring a respirator: 0 Contact Lenses 0 Glasses 0 None Fit Testing -Results (For Clinical Use..Only) Test Date If No, give reason: Test Completed: 0 Yes 0 No Respirator Type 0N95 Paper 0 Full Pressure Make: Style: Face Negative Pressure 0 Half Face Negative MaskFit Test Date 0 PortaCount ❑ Amlcs Q Model: Size: Fit Test Protocol Used: Quantitative lode1 Number. 8095 Serial Number: 80950148 ccupat onal Fit Tester Model Number: = 3000CE Serial Number: 1193 Overall Fit Factor: ❑ ` Pass C1 Fail Medical Practitioner Print Nattier Medlcal.l'raclidoner Slgnalurer 1011 North Macdill Avenue Tampa, FL 436D7 TAB 4: MOBILE TESTING a) Mobile Testing Location: Strategies • Life Scan has the capability, experience, direct full-time medical staffing, and equipment to provide on -site physical exams at on -site location (s) provided by PCFR. All set-up, equipment, and associated costs will be the responsibility, of Life Scan. All equipment maintenance 11 be performed by Life Scan and will be kept clean and sanitized. All equipment ' 11be kept in optimal working order or repaired/replaced within a onable time frame. Life Scan maintains backup of all equipment as well as servi a contracts to ensure timely replacement as needed. Life Scan has the proven cepa ility of providing all services on -site within the location(s) provided by PCFR (not a motorized vehicle): o ` Physical Exam as outlined in the Scope of Services o Blood Draws (supplies included) o Chest x-rays • Equipment: All equipment used for the Life Scan program is state of the art and owned by Life Scan. The equipment is portable and easily set up by the Life Scan staff. Life Scan will bring portable exam tables as well as all the equipment necessary to completely provide the comprehensive medical and fitness exams. o Ultrasound Units Sonosite, Micromax and M Turbo o EKG Stress Units; Welch Alyn, Laptop computer based o. Treadmill: Will be a stationary unit at the BCFR locations o' Fitness Testing equipment: provided by Life Scan o Audiometry Equipment: Welch Alyn audiometer o Vision: Titrnus Vision Smeller o X-ray: On -site mobile services (Mobilex) o Blood draws at any LabCorp Patient Service Center in Florida or on -site at location(s) provided by PCFR Polk County RFP 13-407 Annual Firefighter Physicals,; b) Scheduling; Timeline: 1. Scheduling: Patient scheduling will be coordinated by PCFR to meet the needs of the department The hours of operation, number of days and program dates will be determined by- PCFR ace riling to • slifts/work hours of the employees and the number of annual irefigliter physicals required. A. Life Sin will schedule patients per. day, 5 days per: week (45 patients) in consecutive weeks to a mmodate the successful completion 'of annual fire tet physicals. 300 to 350 physicals / 9 per day = approximately 8 weeks to complete the Pun. a Additional da will be provided as necessary to accommodate completion of fl firefighter physicals at no additional cost to the County, 2, Implementation Strategy A Phase 1; Site visit with P FR by Life Scan managcinent,team -1 Discuss programi com heats and requirements 2•Determine; "space req meats and coordinate on -site program a. Minimum"4 rooms with waiting area . Physical exam • Cardiopulmonary/fitness evaluations `,.;,':.:-:: :-::.:,.:: ..;':,,.,'.-'.- .,,',,.,,,,',,:,:,'-,,'i', :',::, ■ Ultrasound exams ■ Hearing and Vision'area Plari time line Review and approve P tient Packet Review and approve b ood draw program and LabCorp requisitions Review Fit'for Duty and,Respirator Medical Clearance Reports ` Review aind approve reporting system hasea2; Schedule dates for blood draws and physicals •Nine patients per day in three; intervals of three patients each a example 3 at 8 "00;.3 @ 1100rvam, and 3'@ 2:pm b 'Start time will:be temuned by PCFR . c 'Each physical' ex will require 3 hours (3 patients will rotate between 3 portions of the program including ultrasound,:physical, and cardiopulmonary/furies Polk`CouMy RFP 13-407 Annual Firefighter Physicals -- C. ` Phase 3: Blood draws (2-5 weeks prior to physicals) 1. On -site at any location (s) provided by PCFR 2. LabCorp Patient Service Centers a. Phlebotomists are certified technicians b. Facility meets all requirements established by DOT and is properly licensed. D. Phase 4 Life Scan Physicals 1, Firefighter Physicals 2. Medical Requirements based on NFPA 1582 a. Essential Functions per NFPA 1001 for firefighting professional qualifications E. Phase 5: Reporting per PCFR Requirements ) Scheduling. Timeline for second after the initial physicals. Polk County RFP 13-407 Annual Firefighter Physicals 1 year: Same formula as above within 12 months d) Three (3) References of Govern Mobile testing strategy: 1. Brevard County Fire Rescue ental Agencies that Life Scan has applied this same Contact: Assistant Chief Leslie i-Iogg Phone: (321) 633 2056 Performance Period 2012 to Present Service Provided: LIFE SCAN Program for Firefighters: 2. St Petersburg, Fire Rescue and . Petersburg Police Department Contact Fire Chief James Large Phone (727) 893 7694 Performance P'eno 2008 to present Service Provided , LIFE SCAN Pro for Police and Firefighters: 3. Largo Fire Rescue Contact: Assistant Chief Shelby Willis Phone: (72'7) 235=8455 Performance Period: 2006 to present Service Provided: LIFE SCAN Pro for Firefighters: Life Scan provides this service to o er 150 police, corrections, and fire departments in Cities and Counties in the South astern United States. Other references will be provided upon request. Polk County RFP 13407 Annual Firefighter Physicals. LIVE- SCAN COM EEHENSIVE SAFET The Life Scan Compreheaslye Safety and designed to maintain a gate env ronmentf patients and employees.` Processes for employee safety an►d'so AND SECURITY POLICY' security Polley is a safety management plan ee of hazards and reduce risk of inJaries for • New employee orientation and education program and annual recurrent training that addresses Safety Pro ; ' s i Blood borne pathogen 'licy (Exhibit A) lip, Biohazard waste polio (Exhibit B) b. Processes' and procedures for facilitie and equipment security 1. - Life Scan will coordinate wi the on site facility manager to determine what County procedures proces "s are for specific site as well as best manner to secure equipment during pro c. ` Emerenc P g yPreparedness Plan l: 'ilk Scan wi11 coordinate with the on -site facility manager to determine what County procedures and proces 'es are for specific site. d. Safety- Equipment • 1. Life Scan routinely maintains and tests all equipment. Any equipment utilized will be tested prior to program start ori-site. e. Reporting to County Risk Management regarding accidents and/or damages 1, ` Life Scan management will ive any accident or damage reports and report them directly to`County Riisk anageinent per County procedures. f. ` Records Confidentiality 1. Life'Scanwill coordinate with the on site facility manager to. determine an on -site secure area to score �recordss duiJng program.• 2. Life, Scan stores all patient records in a secure facility=in their corporate office with access limited to authorized Life'Scan employees. 3. Life"can follows all k11PPA, State, and local guidelines regarding patient confidentiality and will review process with the County prior to scheduling. Polk County RFP 13-407 Annual Firefighter Physicals EXHIBIT A SUBJECT: BLOODBORNE PATHOGEN EXPOSURE CONTROL PROCEDURES SOP #005 APPROVED BY: Patrica Johnson, President EFFECTIVE DATE: Sept. 22, 2003 REFERENCE: INTRODUCTION The Occupational Safety and,Hoalth Administration -(OSHA) reports that, 5.6 million employees tin the United States are at risk of exposure to blood' borne pathogens where they work This Bloodoame Pathogen (BBP) Exposure Control Procedure is,designed to` protect all i;ifo Scen Wellness Centers' employees. The authority havirtis{ jueladictlon for,thls.procedure is deriried from the Code.of2Federal.Re ulaiions 19°10.103tl and Flonda"Department of s eal Code cites Ct aptor`64E-16 of.the Florida Adrninis ative Codes. This procedure includes'the following keelements: A. Identification of Job:Classifictlo ans and tasks where there is exposure to blood and other. potentially infectious materials. B.' Methods of Compliance including: Universal precautions, Engineering and work:pra 'ice controls, PersonalI? p` rotective ui ment, �eq p Housekeeping . C. Training of Emplioye►es. D. Hepa tiis,B;Prevenfion E. Post -Exposure Evaluation. F. Procedures for evaluation of circumstances of an exposure incident. G. it will be the responsibility of the L fe Scan Wellness Centers' ,Safety Departrnent to maintain=this pro dure. Life Scan Vllellnass Centers' Bloodberne Pathogen;Exposu Control Procedures"will be accessible to all employees This procedure Will re Or updated annually:by the Life Scan Wellnerl*ss Centers' Safety Department and whenever regulation s change or alterations,in work practices create"anew occupational exposure: Exposure Determination Job. Clsasifications`Liist OSHA defines occupational exposure as those individuals who can "reasonably. anticipate ekineye, mucous membra a or paranteral exposure to blood onto , other pots ti lly infectious ,materiats at may result from die performance ofan employee's; duties " • All Life Scan employees full and part ti " e are to follow • the follow ing guidelines and procedures; mpIoyees will, have mandatory blob born pathogen (BBP) training within ten.(10) s bfmpl dayemployment and on an annual b siis Hepatitis B. immunization will pe offered to a new employee :within ten 10 days 'of memployment at no cost to the employee or,. 'a andatory: with,.right to waiver basis f xthe.'emploYee when hired has; waived `the immunization requirement and later°has an exposure toe BBP, Life Scan must offer immunization to "the employee within 24 hours ;of, the exposure at no ,cost tothe employee The Human=Resources.(HR� Department will make new hire`Blood borne Pathogen>trainmo available to`ali:full.,.time and"part time at.'risk employees. Ongoing training andwbooster sh`otsw+will be made`available lid the employee's supervisor. "If. any employee has an exposure to a, BP, they should complete,the. Report of Injury process and _notify management to create an °incident report. In the"- event' of an exposure to BBP incident If there has: been no prior immunization Hepatitis B immunization must be -offered -Within '24hours at no cost to the employee. Fe Scan will require training on BBP fors all full time and part time at-nsk employees at the time of initial employment acid annually The , instructor is required to be knowledgeable in the subject matter Employees having questions will be directed to.. ztheir health care provider "Training will a adored to the education and language level of the` employees, and offered during, work."hours. The training will be`interactive ano include: -An explanation of the AS An explanation of the mod An explanation .of the Li Control Procedure; and h": H:'standard. of transmission of blood -home pathogens. e Scan Blood Borne Pathogen Exposure w employees can obtain a copy. -The recognition of tasks, which may, involve exposure. \n -explanation of „their, use and limitations, of methods to reduce exposure =i These include engineering controls, work practices, and personal protective equipment (PPE) offered at no cost to all: full time and time employees. Information on the iisposal of °PPE. °cation, handling, decontamination and e basis Of selection of PPE. is' B vaccination (HBV) to include efficacy, ion, benefits. and that it is offered at no- cost �w employees. duress to follow if an exposure incident occurs, )rting and medical follow up he _ Record Information 7 Employee t esources at a minimum for .the-duratic e,followirg Thedates of th -An outline $d aining records shall be maintained in Human n` of employment. These records shall include e`BBP -training; sessions. escribing the materials. presented:. -The names -and qualifications of persons conducting the sessions. The names and persons attendingthe training sessions and signature of each job titles of all employee. ` enters will be resp°ansible for maintaining training records. The time employee wiI be notified that training is' required at the time enters will be responsible for completing an annual review of the training procedureand program, updating it:as necessary. COMPLIANCE (PREVENTION) METHODS Universal precautions will be observed at Life Scan Wellness Centers to prevent contact with blood and 'other potentially infectious: materials. Where .sit is difficult to differentiate between body 'fluid types, all such body fluids shall be considered potentiallyinfectious materials. Universal precautions do not applyto feces, nasal secretions, sputum, sweat, tears, urine and vomitus unless they contain vi ible,blood. The risk of transmission of Human 3 Imrnunodefciency Virus, (HIV) and He atitis B Virus (HBV) from these fluids and materials may be extremely low or none intent However, some of the above fluids and excretions represent a potential source o acquired infections with other' pathogens, and Life Scan Wellness Centers' procedure ,for, preventing the transmission of non-blood` borne pathogens would-be to use universal precautions. Personal Protective Equipment (PPE) *ems!, precautions require that PPE be used where exposure to BBP is possible. Ea h;;department administrator is responsible for ensuring that the following provisions are met: Life Scan Wellness Cente will supply PPE to at -risk employees which is appropriate to their reason lily anticipated blood or potentially -infectious materials exposure.'PPE will be provided free of cost to employees. It will be mandatory that eabh Life Scan Wellness Centers employee (both full and part-time) use the appropriate PPE provided by Wellness Centers in areas where exposure to blood borne pathogens might occur. Each of our at risk employees will be issued properly fitted ` PPE by their department manager. Disposals of contaminated PPE -will be provided to the employees free of cost. PPE examples; are safety glasses, face shields and gloves. Before leaving the work area, employees shall remove all PPE and place it in :a designated container 'for storage_ , washing, decontamination, or disposal as appropriate to the work area. Gloves shall be worn where it is reasonably anticipated that employees may-have;hand contact with blood or other potentially infectious materials and when handling or touching contaminated items or surfaces. If hands. are cut or scratched, doub a gloves should be worn or heavy. duty latex gloves if available.Employees will wear gloves for all blood draws, vaccinations, injections, ultrasound imaging, and handling of -urine cups and-DRE cards. No exceptions. Disposable gloves usecF shall not be washed or re -used after contamination. Disposable gloves; shall be replaced, as soon as their protective ability is compromised,such as being tom or punctured. Gloves shall be used for handling contaminated waste and for clean-up procedures For any at -risk employee who has allergic sensitivity, Wellness Centers will provide. hypoallergenic gloves, or powderless gloves, at not cost to the employe to e p Housekeeping, Engineering and Work " lace Controls Hand washing facilities with antiseptic soap or single : use antiseptic towelettess.will be provided or immediate use, after contamination. At Risk employees will was hands immediately after removing gloves. p Eating, drinking, smoking, applying cosmetics or lip" balm, or handling contact lenses is prohibit gd in work areas where exposure to BBP is possible. Labels and other wamings, as specified in: Code of FederalRejiulatlons 19101030(g), will be affix to - contaminated materials to -"wain others. Life Scan Wellness Cent rs will monitor the Blood borne ,,Pathogen program far contaminated material to be defined as Bio=Hazardous Waste. Contaminated; waste will be handled in the following manner; All ;contaminated waste will be placed into appropriately marked medical waste storagecontainers. The Jacksonville Sherifi's`Office will contract with, a certified biomedical waste disposal company to dispose of wastefor ife Can Wellness Centers: In areas where there:is-to bea clean up of infectious waste material the following procedure:should be followed. Put` on gloves and, other PPE protective equipment as necessary. Post wet ' floor signs if available. Apply a tuberculocidal,, disinfectant over :;the potentially :infectious material in accordance with label directed use. l Clean 'up'the; contaminated material with disposable paper towels and piece and seal in a plastic bag to be disposed of as biomedical waste. Remove gloves and if disposable, discard -in theBiome dical trash container. Wash hands thoroughly. These compliance (prevention) methods will be reviewed annually and updated Life Scan Wellness Centers,as new regulations or information becomes available or When new, employee positions:with--the potential for exposure are created: HEPATITIS B PREVENTION This section ,addresses,:the procedures, which :are to:; be implemented ;to meettthe minimum OSHA standards m reference to HepatitissB Vaccination The procedur implemented yin this sec ion provides °a •means to protect$ both full and part time employees at Life` Scan Wellness Centers from::infection' caused try Hepatitis B: The Hopatitis B vaccination refers. to both the Hepatitis B vaccine and vaccination senes. Ail required services would, be provided o the employee at no:cost >The employee will receive these services. at' the Life Scan- eilness Center The Hepatitis vaccination will be avails le to occupationally -exposed employees after receiving proper training on information relating.:to the Hepatitis B ;vaccine, including information on itssafety efficacy, method of adriministration, benefits of vaccination and that the senriceswill be`provided free of cost. i The Hepatitis B vaccine,will be made available to; the employee within ten {10) working days°of the initial assignment regardless of;which training hasbeen received There are ` " s"to receiving the senes: 1. The employee previously received the complete Hepatitis B series; " • r2 A tibody testi"ng h� 3. The vaccine ls, con s revealed that the employee is immune. raindicated for medical reasons. 4 The employee decrned the vaccine In, this case, if he employee in tially.declmes Hepatitis B vaccination but at a later date, still « covered under.the standard, decides to accept the vaccination, it will be provided to the employee. at no cost at that time If Exception 1, 2, or 3,is relevant to a particular, ployee's case, documentation of applicabilityk of the exception must be obtained and emincluded in the employee's human resource:medical file. If Ihe employee declines the vaccine (Exception 4), the employee must sign the Hepatitis, B declination: form attached hereto "Once completed, this form must be included in the employee's human resourcemedical file. The term "no cost<to the: employee" means there „will be no out of pocket expense to the employee. ,If a routine booster dos e(s) of Hepatitis B vaccine is recommended by the U.S. Public Health Service at a future date, a boost rwill be made available to all employees in the same manner'as described above for He atitis B vaccination. POST` EXPOSURE EVALUATION -°AND OLLOVW UP If employees follow the prevention guid lines as presented in this ,policy, an exposure incident to a BBP should be a rare eV' nt However, if the employee does have an exposure incident it shall be' reported, investigated and documented. Employees who have been exposed to BBP shall rs port .the incident through; normal Worker's Compensation (WC) procedures; by firs notifying their supervisor, completing incident reportand: WC First Report of Injury ports After exposure, all costs of care will be treated as a workman's°'compensation incident. Titers .(or retestinq,of immunization) will be offered after completion of the series if five Vearshas:elapsed since Completing the series. PROCEDURE FOR EVALUATION OF AN EXPOSURE INCIDENT When an exposure incident occurs, it will be the responsibility, of Life Scan management to investigate the circumstances, develop an incident report, distributing it to the President of Life Scan' Wellness Centers OTHER UNREGULATED WASTE Sanitary Napkin Disposal OSHA considers the disposal of sanitary napkins an effective engineering control, against exposure to blood. Sanitary napkins do not require bio hazardous labeling or disposal. Plan Service Workers (PSW) will be provided and it mandated that gloves beworn wh n; handling trash with waste bags being kept away from the hotly OSHA does not generally consider di' carded feminine hygiene products, used to absorb menstrual 'flow, to fall within th definition of regulated waste.=:The intended function of products such as sanitary napkins is to absorb and contain blood; the absorbent material of which . they are composed would, under most circumstances, prevent the:release of blood. OSHA -expects :the waste containers into which these products are;discarded to be lined with,a plastic or a wax paper bag.. Such bags should protect the employee from `physical :contact with the contents. If the. inspection of a sanitary napkin disposal container carries==visible signs of soil, the entire dispenser should be cleaned with an appropriate disinfectant product. Questions, concerns, or remarks regardi : g ,this policy should be directed to Life Scan Wellness Centers'management ree tea tfie•.follow. the. Life•Scan Wellness Center �..F ology exposure con I procedures: President Life Scan Wellness Centers Last Review Date: September 11,, 2012 EXHIBIT B Life Scan Wellness Centers Biohazard Waste Plan Employee Education (Florida Administrative Code 64E-10 Life Scan educator will provide an initial (within 30 days of employment) and yearly education for all employees on the proper handling and disposal of Biohazard Waste. Objectives: The employee will be able to: ▪ identify `sharps': and non -sharps' which is designated as s a `biohazard' identify the `Point of Origin' at the clinic and onsite properly`prepare and store compl ted `sharps' container(s) and/or 'bio-hazard' red bag(s)for scheduled disposal - demonstrate Universal Precaution when handling all potential `biohazard' materials • locate the `Bio`Hazard' binder co taining the most current Health Department guidelines, up to date employee s' `ed education, previous surveys and be prepared with this information for an onsit Health ' Department survey - properly clean up a 'bio-hazard' spill • Bio-hazard S and Non -sharps a. Sharps are considered any needle that has been contaminated with blood whether is be/fromli blood draw, vaccinee injection or a' PPD test. b. Nonsharps°(absorbent or non Is item(s) that are considered "soaked" in blood or, other bodily fluids c nsidered potentially a 'biohazard'. They may be disposable ubber gloves, ext iota tubes used for blood draws, gauze and/or band -aids `-Scant amount of blood is not considered a `biohazard'. 1 Universal Precautions All personnel will need touse proper hand washing before and after the blood draw. Gloves must be worn during a blood -draw and when coming in contact with a contaminated surfaee(s) with bodily fluids. III. Point of Origin and Sharps Disposal a. Point of Ori▪ gin is a room where biohazard waste is generated such' as the designatedrom ofor blood . When working "off site" generated n area will is designated away from potent' lexposure to other people. After utilizing a needle on a a ient whether it is from a blood draw, vaccine or PPD testing, there must be a sharps container within a short distance front the person providing these services. Al needles will be single use and -properly -disposed of immediately There should no cross; contamination Of vaccine or "PPD substances or materials. Any potentially contaminated materials will be documented and disposed of immediately in a Bio-Hazard container. • b: One should be able to use as • util ig one hand If the'aa deposit the>itsed•needle into t dty coveron the needle immediately,; after use le does not have this protective, than immediately sharps container. Sealing and preparing Bio-Hazard Containers for Transport The red "sharps" containers an bags are to include the "Bio-Hazard" symbol and a separate sticker bearing the o ce address label as the place of origin before being picked up by the designa ed disposal company• ebii biohazard red bag will need to be seheduled for pickup within 30 days after All sharps containers need to be securely closed and labeled with the Life Scan label after 34 fioull Transporting bhazards containers in a personal vehicle under 25 pounds is permissible without a permit There will be designated` contained to hold the used sharps boxes and biohazard bags until pickup s container will be of a sturdy.smooth surface and non- permeable € The Life Scan Educator will notify you if this location Location of the `BioHazard' binder containing the most current Health Department Guidelines The' binder will contain the past 3 years of employee education. Each employeeiwill have an initial yearly rreview ; education on the biohazard plan and subsequent The binder will also include all Health Department survey's, which are kept indefinitely. Biohazard Cleanup luipment to were for large spills:i a broken of blood 1 < Protective wear gown, glove's (Heavy rubber), eye protection 2 W isk°:broom, dust pan Pickup the broken glass with the broom and dust Place in sharps container.. Clean`,up using -plain soap and water and place contaminated items'in a biohazard red bag. Clear the area again'using a l 10 blend of 1 o beach and 9 oz water. • _; Asa reminder, all used bio hazard ba s should be labeled with° Life Scan's address and F transported from site by the:designated disposal service within30 days after being first,used. EXHIBIT C: LIFE SCAN EQUIPMENT MAINTAINANCE PROGRAM: Life Scan has routine maintenance and calibration of all medical equipment on an annual basis according to the recommendations of the manufacturers. All equipment maintenance will be performed by Life Scan and will be kept clean and sanitized. All equipment willbe kept in optimal working order or repaired/replaced within a reasonable time frame. Life Scan maintains backup of all;equipment as well as service contracts to ensure timely replacement as. needed. Polk County will have the'ability to inspect Sonosite Ultrasound Unit Welch Alyn Easy One Spirometry Unit Welch Alyn EKG%Stress Unit Welch Alyn AudiometrylUnit TitmUs Vision Tester Polk County REP 13-407 Annual Firefighter Physicals 1 l Attachment "A" COST PAGE Cost per employee forall requirements and items to be performed annually as defined in. the'RFP.Document. Cost shall be inclusive`of all costs associated with` the annual physical exam,including overhead, indirect costs etc $ 00 Per Employee Other costs for additional services to be used by the County on a case by case basis. The prices below must` be separate and will not be included in the cost scoring criteria. Chest X-Ray: Optional annually, required a minimum every five (5) years I$ Respirator Fit Testing (SCBA Face piece. Fit TestlN-95 Respirators) Hepatitis B Test (antigen) $ Hepatitis B Titer (antibody) $' Hepatitis B Vaccine (3'per series) 0 Hepatitis A Test (antigen) $ Hepatitis A Titer (antibody) $w Hepatitis A Vaccine (2 per series) $ PPD Test $ ��? 2 :,-:AFFIDAVIT:;„,,CERTIFICATION 4.� IMMIGRTION LAWS _ SOLICITATION NO ; , 'PROJECT NAME. , Yll� u�l lrs i� �u►�C.:1'�0► � FOLK COUNTY:WILLZNOT INTENTIONALLY AWARD COUNTY CONTRACTS TO ANY CONTRACTOR WHOA KNOWINGLY EMPLOYS UNAUTHORIIZED, ALIEN WORKERS; CONSTITUTING A VIOLATION THE EMPLOYMENT;PROVISIONS.CONTAINED IN:8 U.S C SECTION 1324 a(e) (SECTION 274A(e) :OF THE IMMIGRATION `AND NATIONALITY ACT (aiNA) FOLK COUNTY. MAY CONSIDER THE EMPLOYMENT BY ANY CONTRACTOR:WOF . UNAUTHORIZED ALIENS A VIOLATION F'SECTION 274A(e) OF THE INA. SUCH : VIOLATION BY 1T1E RECIPIENT OF THEE PLOYMENT PROVISIONS CONTAINED IN SECTION 274A(e) OF PTHE " INA S LL -BE GROUNDS .FOR UNILATERAL. . CANCELLATION OF THE CONTRACT BY OLK COUNTY :. BIDDER- ATTESTS THAT THEY ARE:- FU LY `ALL COMPLIANT WITH APPLICABLE IMMIGRATION SLAWS (SPECIFICALLY ' 0 '.THE 1988 IMMIGRATION ACT AND SUBSEQUENT who has produced P�0N/ - g/VDGt?N 7T2 6 (Print or Type Name)' > I Pa2;5OiVas identification..- (Type"of Identificatio4n atfct Number) No ry;Pub, Signature Notary`, Commission Number/Expiration Attachment "B" SUBCONTRACTOR Please list below the name and address of subcontractors to be used in conjunction with this RFP TAB,8 MEDICAL LAB 3 LabCorp Regional Office; Labaratory Corporation of America 5610 8V. LaSa11e Street Tampa, :'33607` ORATORY Life Scan will provide an on site blood drawrogram. Life Scan patients are also able to have blood draws"done at any LabCorp Patient Service Center within the United States. LabCorp Patient Service Centers within 25 miles of Bartow: 1:. LabCorp 214213 EDOEWOOD DR LAKELAND, FL 33803 2. LabCorp is 1120 HAVENDALE BLVD NW WINT R HAVEN, FL 33881 3. LabCorp 3131{LAKEL ND HILLSI3LVD STE 1 LAKELAND, FL 33805 4. LabCorp 1324. STATE ROAD 60 E LAKE WAL S, FL 33853 5. LabCorp 607 S ALEXANDER ST STE 107 110 PLANT CITY, FL 33563 6. LabCorp 2209 NORTH 13LVD W STE a DAVIT ORT, FL 33837 Polk County RFP 13407 Annual Firefighter Physicals LABORA 'ORX NAME AND ADDRESS LABORATORY CORPORATION or AMERICA 561LASALLEST TAMPA, "FL 33807' LABORAS ORY DIRECT OR SEAN FARRIER M.D. Pun rant w 358 of the Yu Secrio . Act (42 U.S. di aba Kaa�ed boraia y 6bwttd .e tks adJww shoe• -forthepwposes ofPeifuaa lth cr it1& to s U bo raid aandl dte data ebt for oftheAtxox LAIR CERTIFICATION (CODFa BACTERIOLOGY (110) MYCOBACTERIOLOGY (115) MYCOLOGY (120) PARASITOLOGY (130) VIROLOGY (140) SYPHILIS SEROLOGY (210) GENERAL IMMUNOLOGY (220) ROUTINE CHEMISTRY (310) URINALYSIS (320) ENDOCRINOLOGY (330) TOXICOLOGY (340) HEMATOLOGY (400) ABO & RH GROUP (510) (ILIA m IVTIb4BFR 10D0289827 EFFECTIVE DATE 04/28/2013 EXPIRATION DATE 04/27/2015 Judith A. Xo.t,l7Nrcaor: DivisEan of Labotatnq Services Sttene� and Ceidficadoti Gia p Casa: for Medlald sad &w 0priadwu bold a. Cestx cc of Cowp lance of CmtEt ate of Accreditodon, below is a lent of the leboiiimsq apc alties/ait6apedaIt you rue certified to perform and dirk .'effective data s 1oil 3/1995 03/04P2013 • 10/1311995 10/13/1995 10/13/1995 10113/1995 10/13/1095 10M311995•`• 09/2012002 10/13N 995 08/15/2003 10/13/1'995. .10/1 3/1995 - LAB C ERI FICATION (COD l IIMMIYEDATE ANTIBODY NON -TRANSFUSION (630) _-10/13/1995 ANTIBODY IDENTIFICATION (54) 07/17/2008 HISTOPATHOLOGY (610) 10/13/1995 ORAL PATHOLOGY (SRO) 04/2912008 CYTOLOGY (630) 08115/2003 FOR MORE INFORMATIONA90UT CUA„ VT SIT I)1JR w.EBSITE AT W W'W CMS.IIHS.GOV%C LIA OR CONTACTYOUR LOCAL STATE AGETNCY PLEASE SEE THE REVERSE FOR SCl7LTR SYAT>; AGENCY'S ADDRESS Al<iD aP>�Ior'rE NUMl3ffiZ. PLEASE COisroci'"'YIDUR"STATE AGENCY FOR'ANY CHANGES TO YOUR CURRENT' CEWTYPICA'A'B es that the laboratory named below on of America oy arr e umber:'2660901 :, 189136 CLIA: Number:10D0289827 MB met -all applicable standards: or accreditation and accredited by the College of American Pathologists' Laboratory Accreditation Program. Reinspection should occur prior o December 14, 2014 to ;maintain accreditation Accreditation does not automatically survive a change in director, ovmership, and assumes that all iuteriin.requirements are met. ,01 Chair,.. Commission oa Laboratory Ammon President, College oi<American Pathologists EDUCATION ,University of South Florida: July.18)1985 to May 1989 Bachelor of Science (Allay 1989) Laboratory lissistant (electron°microscopy) University of South Florida Deparhnent of Pathology and; Laboratory Medicine Volunteer, Shr ner's Hospital (Tampa, FL) University of Son Florida College of Medicine August 1980, to June 1993 Medical Doctor (June, 1993) National l ority TuitionScholarship Physician shadow program 'Volunteer work at the Judeo-Christian Clinics Sumner research sun 1991 with Dr. John $alis (ozone induced la , inJury) University of South Florida Department of Pathology and Laboratory 1VIedidne July 1993 to June 199 Junior "inspector for the College of American Pathologists Diplomats and,certifled It Anatomic Pathology°and Clinical Pathology, October 1999 • Connecticut (12113/99): 38319 - Pennsylvania (10/3o/07): MA433070 Georgia (2/7/08) 060580 Arizona (3/13108): 38314 South Carolina,(6/171: 30533 west Virginia (7/104): 23206 Texas (8/29/08):;' 1s10757 Vice President, Patholgy Serviced Labrorp, Tampa Dates May 12, 2010• to -preset# Ivision; Medical Director Labcorp, Tampa Ces January I,` 2008 to present LVJedlcal Director Liabcorp, T Pa ( Tarnps,FL) 2007 to Decaaber, 2007 ncoast 1' edlcal Clinic (Saint Petersburg, FL) 6tay,2008 r-Lab`cOr- p Galesville (t ainsville,� FL) ly, 2©05 to June, 2008 abcorp Tanxpa (Tamp 'L) ovember ,2004 to Apri12 07 ox Dtati on ms T' pa, ani �� aa� (T pa, FL) anuary,20o1 to October, 2004 Sta_ if Pa#ltotogbit Dianon Systems Tampa ('Tampa, FL) Dates• bJuly, 1998to January Tampa Pathology Laboratories (),am2p001 -FL) ates June,199G to July, 1998 St.,Joseph's Hospital i`ampa, FL) Dates July 1997to July 1998 LabCorp :(Tampa, FL) Dates November,1996 to A:pil, .1997 Corning Laboratories (Tampa, FL) Dates September,1996 to January,1997 Roche Laboratories (Clearwater, FL) Dates Saptembcr,-1996 to Deceniber, 1996 PROFESSIONAL`AFFILIATIONS The College of American Pathologists (194-present) CO E ;v APPO . . alitY Irnprovenaent Coantrtittee Dianon July 1996-June 1997' Surgical Pathology Hospital. July I997-June 199$ Transfusion committ ystems Labcorp January 1, 2001 to present. A committee at the James A Haley Veteran's at the James A. Haley Veteran's Hospital. UBLICATIONS Senn E. Farrier,:Steven Agosti and Micheal Morgan: Metastatic Ependymora .Presenting as Par cytopenia.". Sc ud ern Medical Journal. 87(12): 1262-3, 1994 Dec. Sean E. Farrier and Micheal Morgan. Bcl-2;Expression in Pilomatricomas. American Jornal-o€Derma tho10 1 3 : 2544,1997 Jun. James F. Patterson, Michael D. Hammo Mark R. Montgomery, John T. Sharp, Sean E. Farrier, endJohn U °°Baps Acute O ne=Induced Lung Injury in Rail• Structural- Functional Relationships of Developing Alveolar Edema. -Toxicology and Applied Pharmacology,117 37 511991. AWARDS 1998 :'Resident Research Award for work on the DiGeorge Sequence and the 10p- deletion. LE 1 ' 'IP ti SE TIO Nov. 4,1994 Feb. 21,1996 Feb 21,1997 Dec. 5,1997, la There A Fungus Among Us? .Cas Diseases Astrgoytomas • Tuinorsand Tumor=like Conditions of the Skull Cellular Identity, The HLA System and You Leukemias of Childhood and Infancy Genn Warfare The Role of the Blood Bank in Stem Ce11 Transplantation TAB 10 CONFIDENTIAL ADDITIONAL INFORMATION To give you the ability to;plan for the futire acid assist you in determining the actual cost structure I have attached tle Life"Scan confi ential itemized price list. Our standard testing on P e One arid additi nal testing on Page Two. Life Scan: $ 370.00 . Quantiferon Gold $ 60.00 Hepatitis C: $ -50.00 Total: $ 480.00. Polk County. ItFP 13-407 Annual Firefighter Physicals Life:Scan WellnoSs cent®rs Pul flc Safetj Ptiysical.Exam :PI lcal°Foam (NFPA.1582 compllan) lon Hearing Eiai Skin;: cancer- assessment Personal. Consultation.with°'Pevie"w of testing"results; Canal/o Pu/monwy Assessment ` �3 Ecltocai iogran REistingvEi<C HeartUltrasound) 7 aatimill95tress TQst WRh EKG Carotid: Arteries�U Aortic Aneuryiol u PulmonaryaF.unctionTest , Cancers 4:1. cease Assessment IdaUltrasoUnd�r ` ._,_ �5 Liver Panncri a`s, GallvBladder,.Spleen,'&' Kidney.. Ultrasounds `. Bladder. Ultrasound. tUtrasound >r, orr en(exter al Ovale Testicular Ultrasound for'Men state erg trasound=for en �orEtory� Rests :;; emoccult'Test Urinalysis Lipid Panel' and, Uterus)'; Diabetes Tests (Hemoglobin AlC and:Glucose)`< Complete Blood` Count .Comprehensnie Th tdid Panel. `: P5A;(rren)` stab Iic Ranei = - CA=125 (wcmen) , Fttiess�P� FPA't Fitness and l gility.Evaluation :-` Body Composnlon.Analys Stretching/FtexabiUtj /Endurance Analysis; Nutrition and Diet Recommendations .I?ei^sanai Fitness;-Recarnmendations koalcal,Clearariees OSHA RespiratorMedical::Clearance F'irefighte�r Medical: Clearance Polk County RFP 13-407 Annual Firefighter• Physicals is included InGuded> mdud"ed included included`> included z inclidea mcludec inciudetl included includes`; included included: ,included" ,Included included;; includE inclded`T included'' mcludedrc mcluoed included' included.' includE included, ui ;incuded ':' �noluded included Addiiona Quanttt"e(tin ies Hepatitis B .Test. ;iiapadtts A Test: ;.Chest X;Rey`` walabie >. est)';` !.view with iidiologistrevieik' I 2.vievi► withRadiolist review'' Urine.Dr ugScreen,K1 Panes,-l-Cup•in office Drug Rescreen with confirmations :PAdcal Review:Officer (MRO)`as,indicated Hepatitiss A,;B, 5r Cxt+est each== Hepatitis Vaccines ea senes) shot (A 2 shot series, =3 shot e��6 Titers`(as needed)�;�:;`` PPD'' H(V I OSHA, Respirator,Mask>Fit Testing SCBA (P,ortacount) OSH�I RespiratorM ' `ehOiinestrese anc ;,Tetnusl7 ask Fitt 1 estirig'N95 (Portekibt nt) =ieavy'Metais' (Hazmat) Nicotine/Cotinine Screehing CrAngio PostOfferPolice:and Firefighter;Examinations., Polk County RFP 13=407 Annual Firefighter Physical .50.00, 50`00' 6400:" 50.00 35:00 4500 50:00.; 50.00; 50.00: 25.00 10.00 25.00 28.00 28!00 120 00.` 20.00'; 60;00; 350.00 TBD based on testing requirements