04.03.2012 Agenda Packet

Transcription

AGENDA
REGULAR MEETING OF THE CITY COUNCIL
CITY OF EAST PEORIA, 100 SOUTH MAIN STREET, EAST PEORIA, ILLINOIS
APRIL 3, 2012
DATE: APRIL 3, 2012
TIME: 6:00 P.M.
CALL TO ORDER:
ROLL CALL:
MAYOR MINGUS
COMMISSIONER DENSBERGER
COMMISSIONER DECKER
COMMISSIONER JEFFERS
COMMISSIONER JOOS
INVOCATION:
PLEDGE TO THE FLAG:
APPROVAL OF MINUTES:
Motion to approve the minutes of the Regular Meeting, Working Session and Closed Meeting held on March
20, 2012.
COMMUNICATIONS:
Proclamation proclaiming Sunday, April 15, through Sunday, April 22, 2012, as Days of Remembrance in
memory of the victims of the Holocaust and in honor of the survivors as well as the rescuers and liberators.
Proclamation proclaiming April 2012 as Parkinsons Disease Awareness Month in the City of East Peoria.
Proclamation proclaiming the week of April 8th through April 14th, 2012 as National Public Safety
Telecommunicators Week in the City of East Peoria.
COUNCIL BUSINESS FROM THE AUDIENCE ON AGENDA ITEMS:
PUBLIC HEARING – 6:00 P.M.
“PUBLIC HEARING REGARDING THE INTENT OF THE COUNCIL OF THE CITY OF EAST PEORIA,
TAZEWELL COUNTY, ILLINOIS TO SELL ONE OR MORE SERIES OF GENERAL OBLIGATION
BONDS (ALTERNATE REVENUE SOURCE).”
Discussion of purpose of bonds.
Comments from the audience.
Motion to adjourn.
COMMISSIONER DENSBERGER:
Resolution No. 1112-139 – To approve the payment of bills listed on Schedule No 22.
Second Reading of Resolution No. 1112-131 – To award contract for fill material hauling to Costco Site.
Second Reading of Resolution No. 1112-132 – To award contract for asphalt removal from Costco Site.
Second Reading of Resolution No. 1112-136 – To approve Site Preparation Contract for Mud to Parks
Program for Chicago Lakefront Park Project.
Resolution No. 1112-138 - To accept low bid for Underground Utilities for Target Site.
To be laid on the table for no less than one week for public inspection.
Resolution No. 1112-141 – To accept low bid for erosion control for Target Site.
Resolution No. 1112-142 – Resolution regarding the Third Party Administrator for the City’s Group Health
Insurance Plan.
Resolution No. 1112-143 – Resolution regarding the Prescription Drug Benefit Manager for the City’s Group
Health Insurance Plan.
Resolution No. 1112-144 – Resolution regarding Preferred Physician and Hospital Network for the City’s
Group Health Insurance Plan.
Motion to adopt Ordinance No. 4033 (AN ORDINANCE AMENDING THE SIGN CODE FOUND AT
TITLE 4, CHAPTER 7 OF THE EAST PEORIA CITY CODE FOR THE PURPOSE OF AUTHORIZING
CERTAIN SPECIAL OFF-PREMISES SIGNS.)
Resolution No. 1112-146 – To appoint Tom Brimberry and Jill Peterson as Deputy City Clerks to serve in the
absence of the City Clerk.
Page 2
COMMISSIONER DECKER:
Second Reading of Resolution No. 1112-134 – To authorize three separate contracts for components of the
improvements to Fondulac Drive which the City will undertake in cooperation with the Fondulac Park
District.
Second Reading of Resolution No. 1112-135 – To accept low bid for traffic signals in New EP Downtown.
Resolution No. 1112-140 – To authorize contracts with four separate vendors in connection with the City’s
2012 Street Improvement Program.
COMMISSIONER JEFFERS:
COMMISSIONER JOOS:
Resolution No. 1112-145 - To approve bid proposals from to upgrade the telecommunications center of the
East Peoria Police Department.
MAYOR MINGUS:
COUNCIL BUSINESS FROM THE AUDIENCE ON NON-AGENDA ITEMS.
COMMENTS FROM COUNCIL:
COMMISSIONER DECKER:
COMMISSIONER DENSBERGER:
COMMISSIONER JEFFERS:
COMMISSIONER JOOS:
MAYOR MINGUS:
MOTION TO ADJOURN:
__/s/ Morgan R. Cadwalader_______________________ _______________
City Clerk, Morgan R. Cadwalader
Dated and Posted: March 30, 2012
RESOLUTION NO.
1112-139
April 3, 2012
EAST PEORIA, ILLINOIS
RESOLUTION BY COMMISSIONER
SECONDED BY COMMISSIONER
BE IT RESOLVED BY THE COUNCIL OF THE CITY OF EAST PEORIA, ILLINOIS THAT
THE CLAIMS AS LISTED ON SCHEDULE NO.
22
BE ALLOWED. MR. MAYOR,
I MOVE THAT THE CLERK IS HEREBY AUTHORIZED AND DIRECTED TO ISSUE ORDERS ON
THE TREASURER FOR THE VARIOUS AMOUNTS, TOTALING
$2,440,163.66
AND THE SCHEDULE OF BILLS BE HEREBY ADOPTED AS PRESENTED.
MAYOR
DATE: 03/30/12
TIME: 09:40:42
CITY OF EAST PEORIA
SCHEDULE OF BILLS PAYABLE
PAGE:
18
FINAL TOTALS
INVOICES DUE ON/BEFORE 03/31/12
-----------------------------------------------------------------------------------------------------------------------------------GENERAL CORPORATE FUND
225,600.35
POLICE PROTECTION FUND
23,845.07
FIRE PROTECTION FUND
12,351.62
STREET & BRIDGE FUND
1,941.01
SEWER CHLORINATION
1,143.08
STREET LIGHTING FUND
323.75
EASTSIDE CENTRE
18,465.25
HOTEL-MOTEL TAX
3,626.80
AMBULANCE FUND
3,645.11
W. WASHINGTON ST TIF
WATER & SEWER
SPECIAL ASSESSMENTS FUND
RIVERBOAT GAMING TAX FUND
1,225,095.27
99,080.42
1,500.00
268,657.24
PAYROLL HOLDING ACCTS
554,888.69
----------------
GRAND TOTAL
2,440,163.66
================
Resolution No. 1112-131
RESOLUTION NO. _1112-131_
East Peoria, Illinois
, 2012
RESOLUTION BY COMMISSIONER _______________________________
RESOLUTION AWARDING CONTRACT
FOR FILL MATERIAL HAULING TO COSTCO SITE
WHEREAS, the City has undertaken a project known as the New EP Downtown
Development Project on the former Caterpillar site located in the City’s amended and
expanded West Washington Street TIF District; and
WHEREAS, the City has entered into a Purchase Agreement with Costco
Wholesale Corporation (“Costco”) for the sale of Lot 6 of the Technology Park Subdivision
in the EP Downtown Development Project Area to Costco upon which Costco will
construct and operate a Costco wholesale and retail general merchandise facility with
related amenities; and
WHEREAS, pursuant to the agreement with Costco, the City has agreed to prepare
the building pad site for the Costco facility prior to the turnover of the development site to
Costco; and
WHEREAS, in an effort to timely prepare the Costco development site, the City
sought contract quotes to haul fill material from the Bass Pro Development Site to the
Costco Site for preparation of the Costco building pad site and preparation of the overall
Costco development site (the “Costco Fill Material Hauling Project”); and
WHEREAS, the City desires to approve and ratify the contract award for the Costco
Fill Material Hauling Project to P.A. Atherton Construction, Inc. (the “Contractor”);
NOW, THEREFORE, BE IT RESOLVED BY THE COUNCIL OF THE CITY OF
EAST PEORIA, TAZEWELL COUNTY, ILLINOIS, THAT:
Section 1. The above recitations are found to be true and correct.
Section 2. The contract award to P.A. Atherton Construction, Inc. for the Costco
Fill Material Hauling Project for the Costco development project is hereby approved and
ratified.
Section 3. The Mayor and City Clerk are authorized and directed to execute an
Agreement for the Costco Fill Material Hauling Project with the Contractor (Exhibit A) on
behalf of the City, together with such changes therein as the Mayor in his discretion deems
appropriate, at a total cost not to exceed $19,800.00 for the Agreement; provided,
however, that the City shall have no obligation under the Agreement with the Contractor
until such time as an executed original of such documentation has been delivered to the
Contractor.
APPROVED:
_________________________________
Mayor
ATTEST:
__________________________________
City Clerk
2
Exhibit A
, 2012
RESOLUTION AWARDING CONTRACT
FOR ASPHALT REMOVAL FROM COSTCO SITE
in the EP Downtown Development Project Area to Costco upon which Costco will
construct and operate a Costco wholesale and retail general merchandise facility with
related amenities; and
WHEREAS, pursuant to the agreement with Costco, the City has agreed to prepare
the building pad site for the Costco facility prior to the turnover of the development site to
Costco; and
WHEREAS, in an effort to timely prepare the Costco development site, the City
sought contract quotes to remove the bituminous asphalt under the Costco building
footprint and to mill the asphalt for use at other temporary facilities sites in the EP
Downtown Project Area (the “Costco Asphalt Milling Project”); and
WHEREAS, the City desires to approve and ratify the contract award for the Costco
Asphalt Milling Project to R.A. Cullinan & Son (the “Contractor”);
Section 2. The contract award to R.A. Cullinan & Son for the Costco Asphalt
Milling Project for the Costco development project is hereby approved and ratified.
Agreement for the Costco Asphalt Milling Project with the Contractor (Exhibit A) on behalf
of the City, together with such changes therein as the Mayor in his discretion deems
Contractor.
APPROVED:
_________________________________
Mayor
ATTEST:
__________________________________
City Clerk
2
Exhibit A
MEMORANDUM
March 16, 2012
TO:
Mayor David W. Mingus and Members of the City Council
THRU: Tom Brimberry, City Administrator
FROM: City Attorney’s Office (Scott A. Brunton)
SUBJECT:
Resolution Approving Contract for Site Preparation Services for Mud to
Parks Program / Chicago Lakefront Park Project
______________________________________________________________________
DISCUSSION:
The City has now entered into the agreement with the Illinois Department of Natural
Resources (IDNR) for the Chicago Lakefront Park Project under the “Mud to Parks”
program that will re-develop a former manufacturing site for U.S. Steel along Lake
Michigan into public parkland. In order to prepare the project site for the placement of
silt from the Illinois River, the project site must be cleared of all vegetation material
before such vegetation begins to grow during the upcoming Spring-time weather. With
the recent warm weather in Illinois, this growth period is rapidly approaching. This
vegetation material will be removed by a controlled burning process.
Pizzo and Associates has worked with the Chicago Park District to undertake this
controlled burning process to remove the vegetation material from the project site. The
City, with the assistance of Midwest Engineering (the City’s project engineer for this
project), has negotiated a contract with Pizzo and Associates for this site preparation
work at a cost not to exceed $15,000. The remainder of the site preparation work will
be bid in the near future as a Phase I package for the Chicago Lakefront Park Project.
This Resolution approves the City entering into a contract with Pizzo and Associates in
an amount not to exceed $15,000 for this site preparation work. This contract shall be
funded by the IDNR funds received by the City for this Mud to Parks project.
RECOMMENDATION:
Our office recommends approval of this resolution.
c:
Steve Ferguson
Ty Livingston
Terri Gualandi
Dennis R. Triggs
, 2012
RESOLUTION TO APPROVE SITE PREPARATION CONTRACT
FOR MUD TO PARKS PROGRAM FOR CHICAGO LAKEFRONT PARK PROJECT
WHEREAS, the City has entered into an agreement with the Illinois Department of
Natural Resources (“IDNR”) for a project with the City of Chicago and the Chicago Park
District to assist with the development of lakefront parkland along Lake Michigan at a
former U.S Steel manufacturing site (the “Chicago Lakefront Park Project”); and
WHEREAS, under this agreement with IDNR, as part of the “Mud to Parks” program,
silt will be dredged and removed from the Illinois River between the Illinois River channel
and the Eastport and Spindler Marinas and then transported by barge to the Chicago
Lakefront Park Project site (the “Project Site”); and
WHEREAS, in an effort to prepare the Project Site for the placement of the silt from
the Illinois River under this Mud to Parks program, the Project Site must be cleared of
vegetation material; and
WHEREAS, the vegetation material must be removed from the Project Site in the
very near future prior to the spring-time growth period; and
WHEREAS, the City has negotiated an agreement with Pizzo and Associates, an
approved contractor for the Chicago Park District, to clear the vegetation material from the
Project Site by burning, for a fee not to exceed $15,000 under the terms and conditions
set forth in the contract attached hereto as “Exhibit A” (the “Contract”); and
WHEREAS, the City hereby finds that this Contract with Pizzo and Associates for
site preparation services is in the best interests of the Mud to Parks program for the
Chicago Lakefront Park Project and necessary to ensure that this project can proceed in
2012;
Section 2. The Mayor or his designee is hereby authorized and directed to execute
this Contract with Pizzo and Associates on behalf of the City for the site preparation
services related to the City’s participation in this “Mud to Parks” program for the Chicago
Lakefront Park Project, together with such changes therein as the Mayor in his discretion
deems appropriate, at a total cost not to exceed of $15,000.00 for the Contract; provided,
however, that the City shall have no obligation under the Contract with Pizzo and
Associates until such time as an executed original of such documentation has been
delivered to Pizzo and Associates.
APPROVED:
_________________________________
Mayor
ATTEST:
__________________________________
City Clerk
2
_____________________, 2012
RESOLUTION BY COMMISSIONER DENSBERGER
RESOLUTION ACCEPTING LOW BID
FOR UNDERGROUND UTILITIES FOR TARGET SITE
WHEREAS, the City has entered into a Development Agreement with Cullinan
Properties Ltd for the development of a Target store on Lot 2 of the Commercial Courts
Subdivision in the EP Downtown Development Project Area; and
WHEREAS, pursuant to the agreement with Cullinan Properties, the City has
agreed to provide underground utilities for the Target development site; and
WHEREAS, in an effort to prepare the Target development site, the City has
sought bids for the underground utilities for the Target development site, including water,
sanitary sewer, storm sewer, and related minor earthwork (the “Target Underground
Utilities Project”); and
WHEREAS, the City desires to accept the lowest responsible bid and award the
contract for the Target Underground Utilities Project to Stark Excavating Inc. (the
“Contractor”); see Exhibit A;
Section 2. Stark Excavating Inc. is awarded the contract for the Target
Underground Utilities Project for the Target development site in the EP Downtown
Development Project Area.
Agreement for the Target Underground Utilities Project with the Contractor on behalf of
the City, together with such changes therein as the Mayor in his discretion deems
Contractor.
APPROVED:
_________________________________
Mayor
ATTEST:
__________________________________
City Clerk
2
Exhibit A
1112-141
, 2012
FOR EROSION CONTROL FOR TARGET SITE
WHEREAS, the City has entered into a Development Agreement with Cullinan
Properties, Ltd for the development of a Target store on Lot 2 of the Commercial Courts
Subdivision in the EP Downtown Development Project Area; and
WHEREAS, pursuant to the agreement with Cullinan Properties, the City has
agreed to prepare the building pad site for the Target facility prior to the turnover of the
development site to Cullinan Properties and Target; and
WHEREAS, in an effort to prepare and maintain the Target development site, the
City has sought bids for erosion control for the Target development site, including the
building pad site (the “Target Erosion Control Project”); and
contract for the Target Erosion Control Project to Illinois Civil Contractors, Inc. (the
“Contractor”); see Exhibit A;
Section 2. Illinois Civil Contractors is awarded the contract for the Target
Erosion Control Project for the Target development site in the EP Downtown
Development Project Area.
Agreement for the Target Erosion Control Project with the Contractor on behalf of the
City, together with such changes therein as the Mayor in his discretion deems
Contractor.
APPROVED:
_________________________________
Mayor
ATTEST:
__________________________________
City Clerk
2
Exhibit A
Resolution Nos. 1112-142, 143 and 144
MEMORANDUM
March 30, 2012
TO:
Mayor David W. Mingus and Members of City Council
THRU: Tom Brimberry, City Administrator
FROM: City Attorney’s Office (Scott A. Brunton)
SUBJECT:
Resolutions for the City’s Group Health Care Plan
(1) Resolution Approving Third Party Administrator for the City’s Group
Health Insurance Plan
(2) Resolution Approving Prescription Benefits Manager for the City’s
Group Health Insurance Plan
(3) Resolution Approving Physician and Hospital Network for the City’s
Group Health Insurance Plan
_____________________________________________________________________
DISCUSSION:
The City’s Insurance & Benefits Committee has recently maintained three-year
contracts for the service providers for the City’s self-funded Group Health Care Plan.
These contracts will terminate at the end of the current fiscal year on April 30th. Thus,
the Committee has reviewed these service contracts and has met with each service
provider regarding renewal of their contracts.
As the Committee has found that Consociate-Dansig has provided excellent service as
the Third Party Administrator for the City’s Health Care Plan, the Committee is
recommending entering into a new five-year contract with Consociate-Dansig for these
services for the City’s Health Care Plan. The Committee has further found that
Consociate-Dansig continues to assist the Committee to diligently control the overall
costs of the Plan. The first Resolution approves this five-year contract with ConsociateDansig for these Third Party Administrator services. Additionally, the City has
previously contracted with Hines & Associates for utilization review and large case
management services. Consociate-Dansig works closely with Hines & Associates to
administer benefits provided by the City’s Health Care Plan. This first Resolution also
approves a five-year contract with Hines & Associates.
The Committee has also found that MedTrak Services has provided excellent service
for the City’s Health Plan as the Prescription Benefits Manager. Thus, Committee is
recommending entering into a new five-year contract with MedTrak Services for
continuing to provide these services for the City’s Health Care Plan. The second
Resolution approves this five-year contract with MedTrak Services.
The third Resolution approves a new five-year contract with Methodist First Choice
network for physician and hospital services for the City’s Health Care Plan. The
Committee did receive quotes for other similar service providers and conducted
interviews with these service providers. After completing this review process, the
Committee found that continuing the City’s relationship with Methodist First Choice
would provide the best cost control for the City’s Health Care Plan, while continuing to
provide excellent services for Plan participants.
RECOMMENDATION:
The Insurance & Benefits Committee, as well as our office, recommends that the
Council pass each of these three Resolutions.
c: Dirk McGuire, Co-Chair of the Insurance & Benefits Committee
Teresa Durm
Terri Gualandi
DRT
, 2012
RESOLUTION BY COMMISSIONER _________________________________
RESOLUTION REGARDING THE THIRD PARTY ADMINISTRATOR
FOR THE CITY’S GROUP HEALTH INSURANCE PLAN
WHEREAS, the City of East Peoria maintains a self-insured group health care plan
(“Plan”) for the benefit of its employees and retirees, and the City’s Insurance and Benefits
Committee oversees the Plan; and
WHEREAS, as part of the contract renewal process related to the Plan, the
Insurance and Benefits Committee reviewed the service received during the past three
years from Consociate Inc. for the Plan’s third party administrator services for
administration of benefits under the Plan, determining that the service from Consociate
Inc. has been excellent and that Consociate Inc. has assisted the Plan with maintaining
cost controls during this period; and
WHEREAS, Hines & Associates Inc. has assisted the Plan and Consociate Inc. by
providing specialized large case management and utilization review services for the Plan,
and the Insurance and Benefits Committee has also found the services provided by Hines
& Associates to be excellent and important to assisting the Plan with maintaining cost
controls during this past contract period; and
WHEREAS, based on strong track record of service from Consociate Inc., the City’s
Insurance and Benefits Committee unanimously recommends that the City enter into a
new five-year contract with Consociate Inc., attached as “Exhibit 1”, for the claims
administration and related services for the City’s Plan, and based on strong track record of
service from Hines & Associates Inc., the Insurance and Benefits Committee unanimously
recommends that the City enter into a new five-year contract with Consociate Inc.,
attached as “Exhibit 2”, for specialized large case management and utilization review
services for the City’s Plan
Section 1. The City adopts the recommendation made by the Insurance and
Benefits Committee, as set forth above, thereby approving the Service Agreement with
Consociate Inc., attached as “Exhibit 1”, which will be effective from May 1, 2012, through
April 30, 2017.
Benefits Committee, as set forth above, thereby approving the Service Agreement with
Hines & Associates Inc., attached as “Exhibit 2”, which will be effective from May 1, 2012,
through April 30, 2017.
Section 3. The Mayor, or his designee, is hereby authorized and directed to
execute the Service Agreement with Consociate Inc., attached as “Exhibit 1”, and the
Service Agreement with Consociate Inc., attached as “Exhibit 2”, together with such
changes therein as the Mayor in his discretion may deem appropriate; provided, however
that such agreements shall not be binding upon the City until an executed original thereof
has been delivered to the respective service provider. Furthermore, the City Administrator
shall be authorized to execute any agreement or documentation that is ancillary to fulfilling
the terms and intent of the attached Service Agreements with Consociate Inc. and Hines &
Associates Inc.
APPROVED:
ATTEST:
_____________________________________
City Clerk
__________________________________
Mayor
Exhibit 1
SERVICE AGREEMENT
This Agreement is entered into by and between HINES & ASSOCIATES, INC. (hereinafter referred to
as HINES) and CONSOCIATE DANSIG (hereinafter referred to as THE CLAIM PAYER) on behalf of
CITY OF EAST PEORIA (hereinafter referred to as THE GROUP),
WHEREAS, HINES desires to provide utilization review services and other services for the
management of Health Care claims of the members of THE GROUP,
WHEREAS, THE GROUP desires to obtain utilization review services and other services from
HINES, for the management of such Health Care claims of the members of THE GROUP,
WHEREAS, it is the purpose of this Agreement to establish a relationship whereby HINES will
perform the services (hereinafter referred to as SERVICES ) as described on Exhibit 2 and Exhibit 3 for
THE GROUP,
WHEREAS, HINES warrants that it will provide the utilization review SERVICES required under this
Agreement in a prompt, efficient, effective and economic manner,
NOW THEREFORE, in consideration of the mutual covenants and promises contained herein, the
parties covenant and agree as follows:
1.
SERVICES AND DEFINITIONS. See Exhibit 1 (attached and made a part hereof).
2.
SCOPE OF SERVICE. HINES agrees that for the term of this Agreement as set forth in
Section 3 hereof, it will provide to THE GROUP the SERVICES outlined on Exhibit 2 and Exhibit 3 with
respect to medical care proposed for eligible members of THE GROUP and for their eligible dependents
(hereinafter collectively referred to as "Covered Persons"), covered under the health benefits programs
established and maintained by THE GROUP. Covered Persons whose primary coverage is to be
provided by another health program, Medicare or Workers Compensation will not be included in the
category of Covered Persons for which SERVICES are performed.
THE GROUP will interpret the benefit plan, maintain a list of eligible employees and dependents as
well as pay the Health Care claims.
HINES will make recommendations to THE GROUP on the medical necessity and/or appropriateness
of Health Care SERVICES provided or proposed to be provided as defined by and in accordance with
those SERVICES that require precertification as listed on Exhibit 2 and Exhibit 3. HINES and THE
GROUP agree that only THE GROUP will make the final determination as to payment or the denial of
payment of any claim and/or authorization for delivery of any Health Care SERVICES.
3.
TERM AND TERMINATION. This Agreement shall be for a term of five (5) years from the
effective date of May 1, 2012 and shall automatically renew for twelve-month periods thereafter with sixty
(60) days notice of any pricing changes. Either party may terminate this Agreement at any time after the
initial year by giving written notice to the other party at least thirty (30) days before the date of termination,
which date shall be specified in the notice.
Either party may terminate this Agreement in the event of a material default, other than a failure to
pay by the other party. Such termination shall be effective thirty (30) days after written notice specifying
the default has been given to the defaulting party, unless the default has been cured before the end of the
thirty (30) day period.
This Agreement may be terminated immediately by HINES for failure to receive payment from THE
GROUP within thirty (30) days of its due dates set forth in Section 8 of this Agreement, except said failure
to pay must be in writing delivered to the parties described in Section 13 and THE GROUP shall be given
ten (10) working days notice from the date of default to cure any default in payment. A dispute as to the
number of participants eligible shall not in and of itself be the basis for termination.
4.
NOTICE OF DETERMINATION AND CONTACT. HINES agrees to contact THE GROUP or
THE CLAIM PAYER designee, the patient, the patient's physician and/or the hospital regarding HINES
recommendations on the medical necessity and/or appropriateness of Health Care SERVICES provided
or to be provided to the Covered Persons.
5.
PROFESSIONAL SERVICES. HINES agrees to secure or provide the services of licensed
physicians as reasonably required to act in the capacity of advisors or consultants to assist in making
review determinations.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 2
HINES agrees to provide a telephonic answering system to be utilized during non-business hours,
holidays and other closed office situations according to the guidelines of the Utilization Review
Accreditation Commission (URAC), also known as the American Accreditation Health Care Commission,
Inc.
HINES will maintain any applicable state licensures and conform to all applicable laws in all
applicable jurisdictions. HINES will notify THE CLAIM PAYER and THE GROUP within thirty (30) days in
the event its license in the applicable jurisdiction is relinquished or revoked. HINES maintains URAC
Accreditation for Utilization Management, Case Management and Disease Management.
6.
INSURANCE COVERAGE AND ELIGIBILITY. HINES will provide written or verbal notification
that HINES is certifying medical necessity and does not guarantee eligibility, benefit coverage or
payment. Payment will be based on THE CLAIM PAYER s review to determine eligibility and availability
of benefits at the time SERVICES are rendered. All questions regarding claim issues are referred to THE
CLAIM PAYER. HINES shall have no legal liability or financial responsibility in connection with claim
payment or denial decisions by THE CLAIM PAYER or THE GROUP.
7.
REPORTS. HINES will provide THE GROUP with electronic reports of its activities under this
Agreement as outlined in Exhibit 2.
HINES agrees to provide THE GROUP with HINES standard reports and will customize the form if
possible under the existing program. Ad hoc reporting fees may apply.
8.
FEES AND PAYMENT. THE GROUP agrees to pay HINES a fee in the amount shown in
Exhibit 2 (attached and made a part hereof) for the SERVICES. Fees specified on Exhibit 2 will remain in
effect for the time period specified in Section 3 of the contract, thereafter to be negotiated upon renewal.
If THE GROUP requests SERVICES or negotiations by HINES and later chooses not to use the
information obtained by HINES, the time spent by HINES is still payable by THE GROUP. THE GROUP
will pay HINES within thirty (30) days of the invoice date for SERVICES already rendered.
9.
ACCESS TO RECORDS AND ASSISTANCE. HINES agrees that during normal business
hours, THE CLAIM PAYER shall have access to and the right of examination of records, which relate to
any SERVICES provided to THE GROUP under this Agreement. Such access and right of examination
shall continue to be provided to THE CLAIM PAYER for a period of six (6) months following the
termination of the Agreement and consistent with the Health Insurance Portability and Accountability Act
of 1996 (HIPAA) and any amendments as dictated by federal law.
HINES will, upon request of THE GROUP, provide reasonable assistance to THE GROUP or patient
in the event legal action is brought to collect amounts which are billed for medical SERVICE(S) rendered
following a HINES determination and notice (as specified in Section 2 of the Agreement) that the
SERVICE(S) was not medically necessary and/or not appropriate. HINES will:
a. Provide access to HINES' review records relating to SERVICES provided under this
Agreement, which are directly related to the subject matter of the litigation.
b. Make available the appropriate HINES' employee(s) to comment regarding the basis
upon which the determination was made that the rendered SERVICE was not medically
necessary and/or appropriate.
c. Make available, at THE GROUP'S expense, the appropriate physician advisor or
consultant, to comment regarding the basis upon which the determination was made
that the rendered SERVICE was not medically necessary and/or appropriate. HINES
and its physician advisors and consultants will be reimbursed by THE GROUP in
connection with such litigation assistance for reasonable out-of-pocket expenses
incurred for travel lodging, meals of employees, physician advisors, and consultants.
10. EXTERNAL APPEALS. If an external appeal is requested, HINES will cooperate with THE
CLAIM PAYER regarding release of information necessary to conduct this level of peer review. HINES
will not pay the cost of the external appeal but will assist THE CLAIM PAYER in locating the external
review organization.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 3
11. COMMUNICATIONS AND CONFIDENTIALITY. Any communications relating to HINES'
SERVICES under this Agreement prepared for distribution by HINES or THE GROUP to any person or
entity, including physicians, Covered Persons, or to the general public will be released only after
consultation between HINES and THE GROUP and only in accordance with applicable state and federal
law governing the confidentiality of patient medical records. Upon mutual agreement HINES or THE
GROUP may communicate with Covered Persons, physicians, and hospitals regarding review decisions
or the review mechanisms to be utilized or modified under this agreement and in accordance with HIPAA
and any amendments as dictated by federal law.
The data furnished in accordance with this Agreement is Confidential Information and any use,
furnishing, disclosure, publication, or revealing in any way by either party of Confidential Information
furnished under the terms of this Agreement to any person, organization, firm, or government agency
contrary to law or to the provisions of this Agreement shall obligate the party failing to maintain the
confidentiality of Confidential Information to indemnify and hold harmless the other party from any claim,
injury, damage, liability, judgment, or expense arising from that party s failure to maintain the
confidentiality of said Confidential Information occurring during the term of this Agreement or thereafter,
except to the extent any such loss or damage was caused or contributed to by the party seeking
indemnity.
In the event either party is served with a subpoena, request for production of documents or similar
legal process relating to review decisions or the review mechanisms to be utilized or modified under this
Agreement, such party shall promptly notify the other party of the service of such process so that such
other party may determine whether any Confidential Information is or may be included in materials sought
by such subpoena, request or process. Such party may at its own expense, take such legal action, as it
deems necessary to preserve the confidentiality of its data or information.
12. INDEMNITY. HINES shall be solely liable for all of its review decisions and those of its
employees, agents or other representatives or designees. HINES will provide its own policy of liability
insurance with a minimum three million ($3,000,000.00) dollar coverage. THE GROUP shall be solely
liable for all of THE GROUP S payments, claim payment decisions, and eligibility and coverage
determinations, and those of its employees, agents or other representatives or designees.
THE GROUP shall indemnify and hold harmless HINES, its directors, officers, agents and employees
for any and all claims, injury, damage, liability, judgment and expenses, including any reasonable attorney
fees and expenses, arising out of a HINES determination of the absence of medical necessity or
appropriateness of SERVICES unless the determination is attributable in whole or in substantial part to an
error, omission, or negligent act of HINES, its agents, employees, or other representatives or designees.
HINES shall indemnify and hold harmless THE GROUP and its directors, agents, officers or
employees from and defend against any and all claims, lawsuits, judgments, settlements and expenses,
including reasonable attorney s fees, caused by the negligence or willful misconduct of HINES.
Where HINES is named a nominal defendant, in a proceeding wherein the issues concern coverage
or eligibility for benefits under THE GROUP S benefit plan, THE GROUP shall defend HINES without cost
to HINES, and/or indemnify HINES for any and all costs incurred by HINES in defending the action,
including without limitation attorneys fees. Notwithstanding this provision, the tender of the defense of
this matter shall not include any authority to settle the matter without the express written consent of
HINES.
It shall be the responsibility of THE GROUP and/or THE CLAIM PAYER, to select services that reflect
the requirements of the benefit plan and any other parties, such as stop loss.
It shall be the responsibility of the Plan Sponsor or designee to notify HINES of the Plan grandfather
status, and of any changes grandfather status or contribution rates at least 30 days in advance.
13.
MISCELLANEOUS. The following miscellaneous terms shall apply to this Agreement:
a. This Agreement shall be governed in all respects by the laws of the State of Illinois,
except to the extent that federal law applies.
b. HINES shall not enter into an incentive payment provision contained in a written
contract or any other type of Agreement with a Health Care provider that is based on
reimbursement or refund for the SERVICE performed.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 4
c.
In the event any provision of this Agreement conflicts with law or if any provision shall
be held illegal or unenforceable or partially illegal or unenforceable by a court with
jurisdiction over the parties to this Agreement, then such provision shall be construed
and enforced to such extent as it may be a legal and enforceable provision, and all
other provisions of this Agreement shall be given effect separately therefrom and shall
not be affected thereby.
d. The terms of the Agreement, including its Exhibits constitute the entire Agreement
between HINES and THE GROUP. This Agreement, including its Exhibits supersedes
all prior communications, representations or Agreements, verbal or written, between
HINES and THE GROUP with respect to the subject matter thereof.
e. This Agreement shall be binding upon and inure to the benefit of the parties hereto and
their respective successors and assigns. This Agreement may be assigned by either
party without the written consent of the other.
f. This Agreement may be executed in several counterparts, each of which shall be
deemed an original, but all of which shall constitute one and the same instrument.
g. All notices required or permitted shall be sent certified, courier service or personal
service delivery mail with return receipt requested and postage prepaid to:
Judith C. Hines, President
HINES & ASSOCIATES, INC.
14 North Riverside Avenue
St. Charles, IL 60174
and/or
Travis Schmid, VP Marketing
CONSOCIATE DANSIG
On Behalf Of
CITY OF EAST PEORIA
111 E. Decatur; PO Box 1068
Decatur, IL 62525
or addresses subsequently furnished in accordance with the terms thereof. All notices
will be deemed effective upon receipt.
h. The provisions of section 9, 10, 11, 12 and 13 shall survive the termination of this
Agreement.
IN WITNESS WHEREOF, the duly authorized representatives of the parties have executed this
Agreement as of the day and year written below.
DATED:
DATED:
HINES & ASSOCIATES, INC.
CONSOCIATE DANSIG
On Behalf Of
CITY OF EAST PEORIA
BY:
BY:
JUDITH C. HINES
President
TRAVIS SCHMID
VP Marketing
CITY OF EAST PEORIA
BY:
PRINT NAME:
TITLE:
DATED:
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 5
EXHIBIT 1
SERVICES AND DEFINITIONS
Acute Inpatient Review - Medical/Surgical:
This is precertification and concurrent review of the medical necessity of an inpatient admission in
an acute care hospital. An admission is classified inpatient when the provider charges an actual
Room and Board rate, rather than an Observation rate for each night the patient is confined.
Acute Inpatient Review - Behavioral Health/Substance Abuse:
This is precertification and concurrent review for acute hospital confinement for patients with a
behavioral health disorder or drug or alcohol abuse. This does not include partial hospitalization,
sub-acute or residential treatment programs.
BABE
SM
Critical Care Program:
Specialty high-risk neonatal care management by board certified neonatologist(s) and specialty
NICU nurse(s). Service includes peer-to-peer consultations with Hines' perinatologist and
attending physician to promote successful outcomes and efficient care.
Behavioral Health/Substance Abuse Case Management:
The process of working directly with patients, their families, and providers to coordinate the
delivery of cost effective, quality care to promote optimal outcomes for patients with acute
behavioral health or substance abuse conditions requiring alternative levels of care, such as
partial hospitalization and residential care.
Case Management Prescreen:
An evaluation of the merits of the case to determine if active case management will likely result in
cost savings to the health plan. This prescreen includes a review of notifications and may include
review of diagnostic code and/or contact with the patient, provider and/or claim payer.
Claim Payer:
A designation given to those professionals who review and adjudicate medical, dental, and/or
disability claims. Designated by THE GROUP to act on their behalf.
Concurrent Review:
The process of validating the medical necessity and appropriateness of continued acute inpatient
stay after the initial certification has expired.
Consultant:
An agent or broker designated by THE GROUP to consult on their behalf with regard to securing
benefits, insurance, claims payer, managed care SERVICES or other SERVICES as designated
by THE GROUP.
Covered Person:
Any person satisfying the plan definition of a covered person under a specific plan or policy for
whom health insurance benefits are provided in whole or in part by THE GROUP. Covered
Persons whose primary coverage is to be provided by another health program, Medicare or
Workers Compensation will not be included in the category of Covered Persons for which
SERVICES are performed.
Dialysis Case Management:
The process of working directly with patients, their families and their physicians to coordinate the
delivery of cost-effective, quality care to promote optimal outcomes for patients neeeding dialysis
for end stage renal disease.
Discharge Planning:
The process of evaluating anticipated home or aftercare needs of patients confined in the
hospital. Routine discharge planning is done under the concurrent review process and complex
discharge planning is done under case management. Aftercare services anticipated lasting more
than one to two weeks or that requires onsite evaluation or coordination of multiple services or
complex treatment plans are handled through case management. Case management handles all
discharge planning when the case is open to case management for continuity.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 6
Disease Management:
A process designed to improve outcomes and reduce costs of poorly managed chronic medical
conditions as evidenced by complications and disproportionate use of medical services through
coordination of care based on clinical practice guidelines and education of the Health Care
consumer for better self-management.
External Appeals:
A peer review that is performed by an entity that is not associated with THE CLAIM PAYER or
HINES.
Health Care Provider:
An organization that provides Health Care services for or on behalf of a claimant.
Health Insurance Portability and Accountability Act of 1996 (HIPAA):
A federal law establishing certain standards that parties intend to satisfy including requirements of
the Administrative Simplification provision of the Health Insurance Portability and Accountability
Act of 1996 (HIPAA) and codified at 45 C.F.R. parts 160 and 164 (Privacy Rule) to the extent
applicable to each party and as may be amended from time to time.
Home Health Care:
Review may include skilled nursing, physical therapy, occupational therapy, speech therapy or
certified nursing assistant visits that are intermittent and provided by a licensed registered nurse,
licensed therapist or certified nursing assistant to assess or treat a patient that is housebound.
Continuous home care done hourly rather than intermittently is not precerted through utilization
review. See Exhibit 2 for identified services.
Hospice:
A service designed to provide supportive care to the terminally ill. Generally the services,
including skilled nursing visits, certified nursing assistants for personal care, therapists for
evaluation and teaching, medical social workers, volunteer and clergy visits are home based,
however many home hospice agencies do have agreements with inpatient facilities to provide
respite or skilled care when needed.
Hospital Admission:
Acute level inpatient care with assignment to room and bed, not outpatient or observation care
unit.
Large Case Management:
delivery of cost-effective, quality care to promote optimal outcomes for patients with catastrophic
conditions.
Large Case Management Identification:
The process of screening potentially catastrophic cases to determine if case management can
positively impact the cost or health outcome for the patient.
Medical Peer Review:
Peer Review services include all reviews done by a HINES physician panelist for medical
necessity of transplant services and any other questions requested by the payer to assist with
claims determinations, including but not limited to necessity of services not reviewed under UR,
coding or billing issues and opinions. An additional fee is charged and a written report is
provided.
Medically Necessary:
Services or items reasonable and necessary for the diagnosis or treatment of illness or injury
according to accepted standards of medical practice.
Nominal Defendant:
A nominal defendant shall refer to Contractor s participation in a lawsuit by being named as a
defendant not because any specific relief is requested against Contractor and/or not because
Contractor is liable in damages under any applicable and tested legal theory, but because
Contractor is connected with subject-matter giving rise to the lawsuit.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 7
Nurse Consultation:
Review of claims or requests for services for medical necessity or cost effectiveness as
requested by THE CLAIM PAYER, onsite evaluations and shock loss reports.
Observation Confinement:
An observation confinement is a short stay in an acute care hospital where the patient is
observed to determine the need for full inpatient admission. These confinements are generally
23 hours in length or less and billed by the facility at less than the normal room & board rate.
Oncology Case Management:
The process of working directly with patients, their families and their physicians to coordinate
the delivery of cost-effective, quality care to promote optimal outcomes for patients with cancer.
Outpatient Behavioral Health/Substance Abuse Review:
The process of reviewing non-acute levels of care, where the condition does not require an acute
inpatient stay. This review includes partial hospitalization programs (PHP), also referred to as day
hospitals. Treatment usually is six hours per day and at least five days per week. This level is
usually used post-acute inpatient to transition the patient to home in a structured level of care.
This review also includes intensive outpatient treatment (IOP). Usually three hours in the
evening. Number of days per week varies from three to six. This is less restrictive than PHP, but
gives the patient intense education and therapy. The service can also be used post inpatient for
those that do not require the more restrictive, structured PHP. Review may include outpatient
therapy sessions. See Exhibit 2 for identified services.
Physician Advisory Service:
Physician Advisory Service includes reviews done by a HINES physician panelist for medical
necessity of a treatment or SERVICE that is contracted to be reviewed under the HINES UR
program.
Potential Shock Loss Notification:
Written notification to THE CLAIM PAYER only, of potential high dollar claims cases, when such
cases are identified and based solely upon the information made available to HINES.
Identification is not made based on claim history, but rather on the diagnosis or information made
available to HINES regarding the potential treatment plan. By providing this Notification, HINES is
not assuming any obligation for THE GROUP or the administrator/THE CLAIM PAYER to notify
the MGU/stop loss carrier or reinsurer of a potential high dollar claim. This Notification is sent as
a courtesy only and does not imply that HINES is assuming, or intends to assume, any liability for
the Notification or the failure to provide such Notification.
PPO Channeling:
The process by which the nurse reviewer educates the provider or patient to the benefits of
utilizing a PPO network provider. This usually occurs prior to a prospective confinement.
Preadmission Review or Precertification or Utilization Review:
The process of validating the medical necessity of a proposed or emergent acute inpatient
hospital admission.
Quarterly Data Reports:
Reports compiled from the data accumulated during a given quarter reflecting the utilization
review activity of a specific employee group or claims administrator. Reports can be customized
to meet specific needs of the customer.
Reconsideration & Appeal:
The process by which a patient or provider can request a review or a peer-to-peer discussion of a
non-certification determination (denial) between the HINES reviewing physician and the attending
or treating physician. Appeals are billed at the current hourly Medical Peer Review rate.
Retrospective Review:
The process of validating the medical necessity and appropriateness of a hospital confinement or
a procedure after the patient has been confined or the procedure has been completed.
Retrospective reviews are generally done by medical record review.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 8
Shock Loss Research Report:
A prospective detailed report that anticipates Health Care needs and estimates the cost of
expected services over a designated period of time, for a specific enrollee with a specific
diagnosis. This report is provided at an additional fee.
Skilled Nursing Facility:
An institution or distinct part of an institution designed for the person who needs short-term,
comprehensive inpatient care following an acute illness, injury, exacerbation of an existing
disease process, or post operative care. The patient must require the services on a daily basis,
the care must be prescribed by a physician, and must require the skills of qualified technical or
professional health personnel.
Transplant Case Management:
delivery of cost-effective, quality care to promote optimal outcomes for patients with organ
transplant conditions.
URAC:
Industry accreditation obtained from the Utilization Review Accreditation Commission, also known
as the American Accreditation Health Care Commission, Inc.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 9
EXHIBIT 2
CITY OF EAST PEORIA
This Exhibit of the Service Agreement is effective beginning May 1, 2012 through April 30,2015.
$ 1.45
Utilization Review Per Employee Per Month Billing**
Acute Inpatient Medical/Surgical and Behavioral Health / Substance Abuse Review
- Preadmission Review
Large Case Management Identification
- Concurrent Review
PPO Channeling
- Retrospective Review
Quarterly Data Reports
Discharge Planning
REPORTING:
Quarterly Reports Included
Ad Hoc Reports Varying Pricing
OTHER SERVICE FEES AS OF May 1, 2012 through April 30, 2015:
Large Case Management fee (in 10 minute increments) $115.00 per hour
The following SERVICES are billed at the hourly large case management fee:Home Health
Care, Hospice, Skilled Nursing Facility. If at any point a physician review is required,
SERVICES will be charged at the current Physician Review Fee rate. Charges for record
acquisition will be passed through to THE GROUP/THE CLAIM PAYER.
Disease Case Management fee (in 10 minute increments) $115.00 per hour
Shock Loss Research Report fee (in 10 minute increments) $125.00 per hour
Nurse Consultation fee (in 10 minute increments) $115.00 per hour
Physician Review Fees (in 15 minute increments) $425.00 per hour
Includes Peer Review for medical necessity with a minimum 30 minute charge; Appeals;
Retrospective Reviews requiring a Physician review and/or any other Physician Consultation.
Charges for record acquisition will be passed through to THE GROUP/THE CLAIM PAYER with
a minimum 30 minute charge.
SPECIALTY CASE MANAGEMENT SERVICE FEES AS OF May 1, 2012 through April 30, 2015:
BABESM Critical Care Neonatal Case Management fee (in 10 minute increments) $125.00
per hour
If at any point a physician review is required, services will be charged at the current Physician
Review Fee rate.
Dialysis Case Management fee (in 10 minute increments) $125.00 per hour
Review Fee rate.
High Risk Obstetrical Case Management fee (in 10 minute increments) $125.00 per hour
Review Fee rate.
Oncology Case Management fee (in 10 minute increments) $125.00 per hour
Review Fee rate.
Behavioral Health / Substance Abuse Case Management fee (in 10 minute increments) $
125.00 per hour
Partial behavioral health/substance abuse hospitalization, outpatient behavioral
health/substance abuse, and sub-acute or residential inpatient behavioral health/substance
abuse care are billed at the hourly behavioral health/substance abuse case management fee.
If at any point a physician review is required, services will be charged at the current Medical
Peer Review rate.
Transplant Case Management fee (in 10 minute increments) $125.00 per hour
Review Fee rate.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 10
**These are the contracted SERVICES as relayed to HINES.
Any additional SERVICES included in the plan document may affect the pricing structure.
THE GROUP agrees to notify HINES of any changes
in Stop Loss carrier, broker, consultants and/or plan documents.
On behalf of THE GROUP, I acknowledge the SERVICES, fees and term of this Service Agreement.
CONSOCIATE DANSIG
On Behalf Of
CITY OF EAST PEORIA
Date
Date
PRINT NAME:
TITLE:
CITY OF EAST PEORIA
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 11
EXHIBIT 3
CITY OF EAST PEORIA
This Exhibit of the Service Agreement is effective beginning May 1, 2015 through April 30,2017.
$ 1.55
Utilization Review Per Employee Per Month Billing**
Acute Inpatient Medical/Surgical and Behavioral Health / Substance Abuse Review
- Preadmission Review
Large Case Management Identification
- Concurrent Review
PPO Channeling
- Retrospective Review
Quarterly Data Reports
Discharge Planning
REPORTING:
Quarterly Reports Included
Ad Hoc Reports Varying Pricing
OTHER SERVICE FEES AS OF May 1, 2015 through April 30, 2017:
Large Case Management fee (in 10 minute increments) $125.00 per hour
The following SERVICES are billed at the hourly large case management fee:Home Health
Care, Hospice, Skilled Nursing Facility. If at any point a physician review is required,
SERVICES will be charged at the current Physician Review Fee rate. Charges for record
acquisition will be passed through to THE GROUP/THE CLAIM PAYER.
Disease Case Management fee (in 10 minute increments) $125.00 per hour
Shock Loss Research Report fee (in 10 minute increments) $125.00 per hour
Nurse Consultation fee (in 10 minute increments) $125.00 per hour
Physician Review Fees (in 15 minute increments) $450.00 per hour
Includes Peer Review for medical necessity with a minimum 30 minute charge; Appeals;
Retrospective Reviews requiring a Physician review and/or any other Physician Consultation.
Charges for record acquisition will be passed through to THE GROUP/THE CLAIM PAYER with
a minimum 30 minute charge.
SPECIALTY CASE MANAGEMENT SERVICE FEES AS OF May 1, 2015 through April 30, 2017:
BABESM Critical Care Neonatal Case Management fee (in 10 minute increments) $140.00
per hour
Review Fee rate.
Dialysis Case Management fee (in 10 minute increments) $140.00 per hour
Review Fee rate.
High Risk Obstetrical Case Management fee (in 10 minute increments) $140.00 per hour
Review Fee rate.
Oncology Case Management fee (in 10 minute increments) $140.00 per hour
Review Fee rate.
Behavioral Health / Substance Abuse Case Management fee (in 10 minute increments) $
140.00 per hour
Partial behavioral health/substance abuse hospitalization, outpatient behavioral
health/substance abuse, and sub-acute or residential inpatient behavioral health/substance
abuse care are billed at the hourly behavioral health/substance abuse case management fee.
If at any point a physician review is required, services will be charged at the current Medical
Peer Review rate.
Transplant Case Management fee (in 10 minute increments) $140.00 per hour
Review Fee rate.
CITY OF EAST PEORIA
SERVICE AGREEMENT
PAGE 12
**These are the contracted SERVICES as relayed to HINES.
Any additional SERVICES included in the plan document may affect the pricing structure.
THE GROUP agrees to notify HINES of any changes
in Stop Loss carrier, broker, consultants and/or plan documents.
On behalf of THE GROUP, I acknowledge the SERVICES, fees and term of this Service Agreement.
CONSOCIATE DANSIG
On Behalf Of
CITY OF EAST PEORIA
Date
Date
PRINT NAME:
TITLE:
CITY OF EAST PEORIA
1112-143
_______________________, 2012
RESOLUTION BY COMMISSIONER DENSBERGER
RESOLUTION REGARDING THE
PRESCRIPTION DRUG BENEFIT MANAGER
Insurance and Benefits Committee reviewed the service received during the past five
years from MedTrak Services LLC for the Plan’s prescription drug program benefit
manager for providing the pharmacy benefits under the Plan, determining that the service
from MedTrak Services has been excellent and that MedTrak Services has assisted the
Plan with significant cost savings during this period; and
WHEREAS, based on MedTrak Services’ strong track record of service, the City’s
Insurance and Benefits Committee unanimously recommends that the City enter into a
new five-year contract with MedTrak Services LLC, designated as the First Amendment to
Service Agreement and attached as “Exhibit 1”, as the preferred provider of these
pharmacy benefit management services for the City’s Plan;
Benefits Committee, as set forth above, thereby approving the First Amendment to Service
Agreement with MedTrak Services LLC, attached as “Exhibit 1”, which will be effective
from May 1, 2012, through April 30, 2017.
execute the First Amendment to Service Agreement with MedTrak Services LLC, attached
as “Exhibit 1”, together with such changes therein as the Mayor in his discretion may deem
appropriate; provided, however that such agreement shall not be binding upon the City
until an executed original thereof has been delivered to MedTrak Services LLC.
Furthermore, the City Administrator shall be authorized to execute any agreement or
documentation that is ancillary to fulfilling the terms and intent of the attached First
Amendment to Service Agreement with MedTrak Services LLC.
APPROVED:
ATTEST:
_____________________________________
City Clerk
__________________________________
Mayor
Exhibit 1
FIRST AMENDMENT TO SERVICE AGREEMENT
This First Amendment (“Amendment”) shall modify the Service Agreement, dated effective as of April 1, 2010 (the
“Agreement”), by and between MedTrak Services, LLC (“MedTrak”), and City of East Peoria (“Client”). This Amendment
shall be effective as of May 1, 2012 (the “Amendment Effective Date”), pursuant to the following terms and conditions:
RECITALS
WHEREAS, MedTrak and Client have entered into and are parties to the Agreement; and
WHEREAS, MedTrak and Client now desire to amend the Agreement as set forth herein.
NOW, THEREFORE, in consideration of the covenants and agreements set forth herein, MedTrak and Client agree
to amend the Agreement, upon the Amendment Effective Date, as follows:
TERMS & CONDITIONS OF AMENDMENT
1.
Section 5.1 of the Agreement (under Article 5, TERM) shall be amended and restated in its entirety as
follows:
“The term of this Agreement shall be renewed on the new “Start Date” of May 1, 2012 (“Start Date”), and,
unless earlier terminated pursuant to a valid provision of this Agreement, shall continue in effect for five
(5) years from such date (the “Initial Term”). Following the Initial Term, the Agreement shall be deemed
to be renewed for successive periods of one (1) year each (each, a “Renewal Term”), unless either party
gives the other at least ninety (90) days’ written notice, prior to the expiration of the Initial Term or thencurrent Renewal Term, of the party’s intention to terminate the Agreement, in which case, the Agreement
may be terminated by the notifying party effective upon the expiration of the Initial Term or then-current
Renewal Term, as the case may be.”
2.
Exhibit C (Financial Terms) of the Agreement shall be amended and restated in its entirety as attached
hereto as Exhibit C and incorporated by this reference herein.
3.
Unless otherwise specifically defined in this Amendment, all capitalized terms herein shall have the
meanings ascribed to them in the Agreement. Except as specifically amended by this Amendment, all other terms and
conditions of the Agreement shall remain in full force and effect. In the event of a conflict between any term of the
Agreement and any term of this Amendment, the provisions of this Amendment shall prevail.
IN WITNESS WHEREOF, the parties hereto have executed this Amendment by their duly authorized
representatives on the respective dates written below.
City of East Peoria:
MedTrak Services, LLC:
Signature: _____________________________
Signature: ________________________________
Printed Name: __________________________
Printed Name: _____________________________
Title: _________________________________
Title: ____________________________________
Date: _________________________________
Date: ____________________________________
1
Exhibit C
Financial Terms
Retail Pharmacy Paid Claim Charge
For each Covered Medication dispensed by a retail Participating Pharmacy to an Eligible Member, Client agrees to pay
MedTrak the “Retail Pharmacy Paid Claim Charge”, which is the "Retail Pharmacy Service Fee", plus any applicable sales or
excise tax or other handling or governmental charge (as determined by law), less any applicable Copayment or Deductible, as
described in the Plan. The Retail Pharmacy Service Fee is:



For Brand Drug Products, eighty-two and three quarter (82.75) percent of the AWP of the dispensed medication plus
$1.00, or the U&C, whichever is less; or
For Generic Drug Products, the MAC plus $1.25, or twenty-nine and one half (29.5) percent of the AWP of the
dispensed medication plus $1.25, or the U&C, whichever is least; or
For Compound Drugs, the U&C, not to exceed one-hundred and fifty (150) percent of the AWP of the submitted Drug
Product.
Retail Pharmacy Paid Claim Charge – 84 to 90-Day Supply
For each 84- to 90-day supply of Covered Medication dispensed by a retail Participating Pharmacy to an Eligible Member,
Client agrees to pay MedTrak the “Retail 90 Pharmacy Paid Claim Charge”, which is the "Retail 90 Pharmacy Service Fee",
plus any applicable sales or excise tax or other handling or governmental charge (as determined by law), less any applicable
Copayment or Deductible, as described in the Plan. The Retail 90 Pharmacy Service Fee is:



For Brand Drug Products, seventy-nine and a half (79.5) percent of the AWP of the dispensed medication plus $0.25, or
the U&C, whichever is less; or
For Generic Drug Products, the MAC plus $0.25, or twenty-eight and three quarter (28.75) percent of the AWP of the
dispensed medication plus $0.25, or the U&C, whichever is least; or
For Compound Drugs, the U&C, not to exceed one-hundred and fifty (150) percent of the AWP of the submitted Drug
Product.
Best-In-Class Specialty Pharmacy Paid Claim Charge
The “Best-In-Class Specialty” Participating Pharmacies designated by MedTrak and approved by Client are the exclusive
providers of specialty Pharmacy Services. For each Covered Medication that is a Specialty Drug, as listed in Exhibit B, and
dispensed by the Best-In-Class Specialty Participating Pharmacy listed in Exhibit B, Client agrees to pay MedTrak the “BestIn-Class Specialty Pharmacy Paid Claim Charge”, which is the “Best-In-Class Specialty Pharmacy Service Fee”, expressed
as an AWP discount, plus any applicable sales or excise tax or other handling or governmental charge (as determined by
law), less any applicable Copayment or Deductible, as described in the Plan. The Best-In-Class Specialty Pharmacy Service
Fee is listed in Exhibit B. The Best-In-Class Specialty Pharmacy Service Fee includes the cost of certain “Ancillary
Supplies”, including syringes, needles, and alcohol swabs. The Best-In-Class Specialty Pharmacy Service Fee does not
include the cost of home infusion supplies, devices and in-home nursing services. MedTrak reserves the right to modify
Exhibit B from time to time.
Non-Best-In-Class Specialty Pharmacy Paid Claim Charge
In the event that a Specialty Drug is dispensed from a pharmacy other than the Best-In-Class Specialty Participating
Pharmacy listed in Exhibit B, Client agrees to pay MedTrak the “Non-Best-In-Class Specialty Pharmacy Paid Claim
Charge”, which is the “Non-Best-In-Class Specialty Pharmacy Service Fee” plus any applicable sales or excise tax or other
handling or governmental charges (as determined by law), less any applicable Copayment and/or Deductible, as described in
the Plan. The Non-Best-In-Class Specialty Pharmacy Service Fee is:


For Brand Drug Products, eighty-six percent of the AWP of the dispensed medication plus $2.50; or
For Generic Drug Products, eighty-six percent of the AWP of the dispensed medication plus $2.50.
2
The Non-Best-In-Class Specialty Pharmacy Service Fee includes the cost of certain “Ancillary Supplies”, including syringes,
needles, and alcohol swabs. The Non-Best-In-Class Specialty Pharmacy Service Fee does not include the cost of home
infusion supplies, devices and in-home nursing services.
The Non-Best-In-Class Specialty Pharmacy Paid Claim Charge does not apply to Limited Distribution Drugs. MedTrak will
submit all Claims for Limited Distribution Drugs by Non-Best-In-Class Specialty Pharmacies to Client for authorization.
Administration Charge








For each Paid Claim, Client agrees to pay MedTrak $0.00.
For each Non-Paid Claim, Client agrees to pay MedTrak $0.00.
For each U&C Claim, Client agrees to pay MedTrak $0.00.
For each Claim submitted manually by MedTrak (“Keyed Claim”), Client agrees to pay MedTrak an additional
Administration Charge of $2.50.
For access to the ScriptCHOICE Program, Client agrees to pay MedTrak an additional Administration Charge of $0.15
per Claim.
For each Prior Authorization requiring Pharmacist involvement, Client agrees to pay MedTrak an additional
Administration Charge of $5.00.
For each Prior Authorization requiring a Pharmacist and Physician involvement, Client agrees to pay MedTrak an
additional Administration Charge of $25.00.
For each Vaccine Claim covered by Client and processed through a Participating Pharmacy contracted with MedTrak to
administer Vaccines, Client agrees to pay an additional Vaccine Administration Charge of up to, but not more than, $25
per Claim.
Miscellaneous Charges

Appeal of Coverage Denial – When requested by the Client and approved by the Client, MedTrak will seek an outside
opinion from an independent medical review company. MedTrak will ask the reviewer for an opinion regarding the
medically appropriate use of the prescribed drug, and an evaluation of, and/or interpretation of, the language in the SPD
regarding the use of the drug in question. This process will take between 3-7 business days to complete, and MedTrak
will charge the Client $250 per appeal.
Formulary Program Discounts
Under certain conditions, MedTrak will pay Formulary Program discounts, in the form of Rebates, to Client pursuant to
Section 2.3 of this Agreement and subject to Client’s participation in the Formulary Program and overall compliance with
Section 2.3. Client agrees that Rebate payments are based upon Plan design over which MedTrak has no discretionary
control or authority, and such Rebate payments are subject to change due to various factors, as described in this Agreement.
Rebate payments are made six months after the end of the quarter in which Paid Claims were incurred. Rebates will be paid
to Client as follows:

In the first three (3) contract years of the Initial Term (i.e., from May 1, 2012 to April 30, 2015), the Rebates will be as
follows:

For each eligible Brand Drug Product, as described in Section 2.3.2, that is a Covered Medication dispensed
through a retail pharmacy, MedTrak shall pay Client $8.00.

through a retail pharmacy in an 84- to 90-day supply, MedTrak shall pay Client $16.00.

In the last two (2) contract years of the Initial Term (i.e., from May 1, 2015 to April 30, 2017), the Rebates will be as
follows:

through a retail pharmacy, MedTrak shall pay Client $7.00.

through a retail pharmacy in an 84- to 90-day supply, MedTrak shall pay Client $14.00.
3
The parties’ signatures below indicate their respective agreement and acceptance to the Financial Terms described in
this Exhibit C.
Client Signature
MedTrak Representative Signature
________________________________________
Client Name (Please Print)
________________________________________
MedTrak Representative Name
_________________________________________
Date
________________________________________
Date
4
, 2012
RESOLUTION BY COMMISSIONER _________________________________
RESOLUTION REGARDING
PREFERRED PHYSICIAN AND HOSPITAL NETWORK
WHEREAS, on behalf of the Plan, the City maintains an exclusive preferred provider
network with a local area physician and hospital network for providing medical services and
related services to persons covered under the Plan on a discounted cost basis; and
Insurance and Benefits Committee obtained proposals from the area physician and hospital
networks for providing these medical services and related services to persons covered
under the Plan as the exclusive preferred provider; and
WHEREAS, after reviewing each of the proposals and conducting interviews with
the prospective network administrators, the Insurance and Benefits Committee
recommends continuing the City’s current relationship with Methodist Medical Center of
Illinois and the Methodist First Choice network for providing these medical services; and
WHEREAS, the Insurance and Benefits Committee further recommends that the
City enter into a five-year contract with Methodist Medical Center of Illinois and Methodist
First Choice, Inc., attached as “Exhibit 1”, as the exclusive preferred provider network for
medical services and related services for persons covered under the City’s Plan;
Benefits Committee, as set forth above, thereby approving the Physician Hospital
Organization Agreement with Methodist Medical Center of Illinois and Methodist First
Choice, Inc., attached as “Exhibit 1”, which will be effective from May 1, 2012, through April
30, 2017.
execute the Physician Hospital Organization Agreement with Methodist Medical Center of
Illinois and Methodist First Choice, Inc., attached as “Exhibit 1”, together with such changes
therein as the Mayor in his discretion may deem appropriate; provided, however that such
agreement shall not be binding upon the City until an executed original thereof has been
delivered to Methodist Medical Center of Illinois and Methodist First Choice, Inc.
Furthermore, the City Administrator shall be authorized to execute any agreement or
documentation that is ancillary to fulfilling the terms and intent of the attached Agreement
with Methodist Medical Center of Illinois and Methodist First Choice, Inc.
APPROVED:
ATTEST:
_____________________________________
City Clerk
__________________________________
Mayor
Exhibit 1
Methodist First Choice, Inc.
221 N.E. Glen Oak Avenue
Peoria, Illinois 61636
Telephone Number: (309) 671-8358
PHYSICIAN
HOSPITAL ORGANIZATION
AGREEMENT
st
THIS AGREEMENT, ("Agreement") is entered into as of the 1 day of May, 2012 by and
between Methodist First Choice, Inc., an Illinois corporation ("MFC") and City of East Peoria
("Organization").
WHEREAS, Organization has established a self-insured employee health benefit plan ("Benefit
Plan"), which includes incentives for Members to use the services of MFC Participating
Providers; and
WHEREAS,
Organization desires to designate MFC Network
Providers with respect to Organization's Benefit Plan;
Providers
as a Participating
NOW, THEREFORE,
in consideration of the mutual covenants herein contained and other
valuable considerations, MFC and Organization agree as follows:
1.1
"Benefit Plan" means the plan of employee health care benefits established and
maintained by Organization that describes eligibility to participate, funding, covered
services, benefits, and the terms and conditions on which benefits will be paid to or on
behalf of eligible Members, and that provides financial incentives for Members to use the
services of Participating Providers.
Any plan providing for workers compensation
benefits, automobile liability and disability plans shall not be considered to be a Benefit
Plan hereunder.
1.3
"Clean Claim" means a bill submitted by Participating Provider which details Member
and service information which is reasonably necessary to allow Organization to
adjudicate the claim.
1.4
"Copayment, Coinsurance and Deductible" mean charges, as determined under a
Member's Benefit Plan, for which the Member is financially responsible and which
should be collected directly by a Participating Provider from a Member.
1.5
"Covered Hospital Services" means those health care services that Participating Provider
is equipped, staffed, and licensed to provide and which Participating Provider usually and
customarily furnishes to persons admitted as inpatients or outpatients of Participating
Provider, or persons who present in the emergency room of Participating Provider. In
addition, to the extent set forth in Attachment A, Hospital Services shall include home
care services and hospice services provided through those companies listed in
Attachment A or in the provider directory.
1.6
"Covered Services" means those health care services for which benefits are payable to or
on behalf of Members under the terms of the Health Benefit Plan.
1.8
"Member" means any person who is eligible for benefits for Covered Services under the
terms and conditions of the Benefit Plan.
1.9
"Participating Provider" means a health professional or entity or institutional health
provider that has entered into a written agreement with MFC to provide certain health
services to Members.
1.10
"Utilization Review" means the function performed by Organization or an entity
designated by Organization, to review and determine whether health services provided, or
to be provided, are Covered Services under the terms of the Benefit Plan.
2.1
Term. This Agreement shall become effective on May 1, 2012 and shall continue in
effect for five (5) years thereafter through April 30, 2017.
2.2
Termination With Cause. Except as provided in Section 5.8 below, either Party may
terminate this Agreement for cause upon the material breach of the Agreement by the
other party, provided that the terminating party first gives the breaching party written
notice of such termination specifically identifying the alleged material breach and the
breaching party fails to cure or substantially cure the material breach within thirty (30)
days of receiving said notice.
2.3
Rights Upon Termination. Upon termination of this Agreement, Participating Provider
shall continue to provide Covered Services to Members then inpatients of Participating
facility and entitled to services pursuant to the Benefit Plan until such Members are
discharged or transferred consistent with sound medical practice. Organization shall pay
Participating Provider in accordance with Attachment A of this Agreement for services
rendered by Participating Provider to such Members for a maximum of thirty (30) days
following the termination; thereafter, Organization shall pay Participating Provider's
Billed Charges. Further, Organization and Participating Provider shall continue to fulfill
their obligations under this Agreement with respect to (i) payments due to Participating
Provider, (ii) records maintenance requirements and (iii) insurance requirements.
3.1
Authority and Contracting. MFC utilizes the "messenger model" for all healthcare
contracting activities involving Participating Providers. The Participating Providers are
identified to Organization as those Providers who have agreed to participate in this
Agreement. MFC shall enter into agreements with appropriately qualified health care
providers to deliver Covered Services to Members.
3.2
Credentialing and Quality Assurance. Participating Providers have met and shall, as a
condition of continuing participation in the MFC network, continue to meet its
credentialing standards.
3.3
Accreditation and Participation in MFC. Participating Providers have and shall, as a
condition of continuing participation in the MFC network, continue to maintain all
licenses and regulatory approvals needed to lawfully carry out its performance of this
Agreement, including accreditation by the Joint Commission on Accreditation of
Healthcare Organizations (JCAHO). Evidence of licenses and/or accreditation will be
provided to Organization upon request.
3.4
Notification ofMFC Change. MFC will exercise their best effort to notifY Organization
upon the occurrence of the following events:
(a)
There is a change in the ownership ofMFC,
(b)
There is a change in MFC or Pmiicipating Provider's business address,
(c)
There are additions or deletions to MFC panel of providers; or
(d)
Any situation arises which could reasonably be expected to affect MFC or
Participating Provider's ability to carry out their obligations under this
Agreement.
3.5
Directory of Participating Providers. MFC shall make a Provider Directory available
online and update regularly. MFC may provide copies of the Provider Directory to the
Organization upon request. MFC represents that it has authority to include the names,
addresses, office telephone numbers, descriptions of services rendered and other
information regarding Participating Providers.
3.6
Status ofMFC. MFC is not engaged in the delivery or performance of health care services,
and MFC has no authority to control or direct the manner or method by which a
Participating Provider furnishes healthcare services to Members. MFC is not financially
responsible or obligated to payor in any manner reimburse the Participating Provider.
3.7
Claim Audits. In those instances where an audit of a claim is requested, or where a claim
is disputed by Organization, Organization shall be entitled to audit the books and records
of Participating Provider for the claim involved. Such audit shall be conducted according
to the audit policy of the Participating Provider.
4.1
Necessary Services. Participating Provider will provide Covered Services to Members.
New services developed by Participating Hospitals during the term of this agreement are
not subject to the discounts contained herein and will be negotiated individually.
4.2
Nondiscrimination.
Participating Provider will accept Members as patients on the same
basis and with equal priority as it accepts patients who are covered under other health
plans. Participating Provider shall furnish Covered Services to Members, as prescribed
by the Benefit Plan, in the same manner and with equal priority as Participating
Provider's other patients, without regard to the Member's age, sex, race, religion, physical
or mental condition, or source of payment.
4.3
Medical Records. Participating Provider will establish and maintain Member medical
records in accordance with generally accepted standards. Subject to federal, state, and
local law governing the use and disclosure of patient medical records and information,
Participating Provider agrees to allow Organization or its designee reasonable access to
Members' medical records and other medical information maintained by Participating
Provider for inspection and duplication, at Organization's
expense, to the extent
reasonably necessary for Participating Provider to obtain payment for Covered Services
pursuant to this Agreement.
Organization shall indemnify, defend and hold harmless
Participating Provider for any liability arising from Organization's misuse or improper
disclosure of Members' medical records and medical information obtained from
Participating Provider.
4.4
Insurance. Participating Provider will obtain and maintain, in full force and effect,
professional medical liability insurance in the minimum amounts of $1,000,000 per
occurrence and $3,000,000 in the aggregate.
5.1
Incentives. Organization represents and warrants that the Benefit Plan offers Members
significant financial incentives (Le. a benefit differential of at least 20%) to utilize
Participating Provider as a preferred provider.
Organization shall actively inform
Members that Participating Provider is a preferred provider under the Benefit Plan and of
the advantages to selecting Participating Providers when Covered Services are needed.
5.2
Benefit Plan Changes. Organization agrees to notify MFC at least thirty (30) days in
advance of any change to the Benefit Plan which affects Covered Services, copayment
and/or deductible provisions, or any other change which might affect the scope of
Covered Services and benefits therefor.
5.3
Identification Cards. Organization shall furnish Members with identification cards that
clearly identify coverage by Organization and participation in the MFC network.
5.4
Eligibility Verification.
Organization shall arrange that telephone or online benefit
verification and precertification be available to Participating Provider during normal
business hours to confirm Members' enrollment, eligibility and coverage of benefits. If
Organization is unable to provide verification of coverage, the claim shall be paid at
billed charges without application of any contractual discount.
5.5
Liability Insurance. Organization will maintain general liability insurance in an amount
sufficient to protect Organization, its directors, officers and employees from any liability
which may result directly or indirectly from the performance by Organization and its
employees of the obligations of Organization under this Agreement. Upon request of
Participating Provider, Organization shall provide evidence of such coverage.
5.6
Confidentiality of Rates. The compensation that is payable to Participating Provider
pursuant to the terms of this Agreement will not be disclosed by Organization, except to
the extent required by applicable law or as may be necessary to administer this
Agreement. Organization understands that it is specifically prohibited from leasing or
selling the Discounted Charges to, or otherwise allowing the Discounted Charges to be
used by, any entity that is not a party to this Agreement.
5.7
Utilization Review. Participating Provider will cooperate with the Utilization Review
Program of Organization during the term of this Agreement. However, if a Member is
unable to produce an employer ID card or Organization is unable to provide verification
of coverage, Participating Provider will not be subject to any reimbursement reduction
that may result from the Organization Utilization Review requirements. Any denial of
hospitalization shall occur prior or concurrent to admission. All appeals of a denial shall
be reviewed and determination made no later than 30 days from date of appeal or denial
is forfeited.
5.8
Exclusivity. During the term of this agreement, Organization agrees that it will not enter
into a Provider Agreement with another hospital or ambulatory surgery center not
affiliated with Methodist Medical Center in Peoria County without the express written
consent ofMFC. This will include but not be limited to Peoria Day Surgery Center, Great
Plains Orthopaedics, Soderstrom Skin Institute and OSF Center for Health. If MFC
determine that an agreement has been entered into with another hospital or ambulatory
surgery center, the rates contained on Attachment A will immediately cease to apply to
reimbursements. For claim purposes, MFC will notify Organization of the effective date
of rate termination.
6.1
Billing. MFC shall require Participating Providers to submit claims to the Organization,
on a CMS Form UB04 or 1500, or electronic transmission, as applicable.
6.2
Compensation.
Participating Provider shall be compensated by Organization at the
Discounted Charges (net of any applicable deductible, coinsurance or copayment to be
paid by the Member) set forth in Attachment A when the Organization is primary, for all
Covered Services billed as provided for in Section 6.1.
6.3
Payment.
Organization shall pay the Discounted Charges (net of any applicable
Copayment, Coinsurance and Deductible to be paid by the Member) for all Covered
Services rendered to Members within thirty (30) days following receipt of a Clean Claim.
Each payment shall be accompanied by an explanation of benefits (EOB) showing the
Organization name, Billed Charges, the applicable Discounted Charges, and any
Copayment, Coinsurance and Deductible amounts owed by the Member. All Clean
Claims that are not paid within thirty (30) days of submission to Organization shall be
paid at Billed Charges without application of any contractual discount.
6.4
Emergency Services.
Participating Provider shall be paid in full pursuant to this
Agreement for emergency medical screenings and related treatment mandated by the
Emergency Medical Treatment and Active Labor Act (EMTALA) to determine the
absence or presence of an emergency medical condition and the care required for
stabilization of the emergency medical condition. Participating Provider shall not be
required to obtain preauthorization
for any such services performed pursuant to
EMT ALA. After stabilization or determination of the absence of an emergency medical
condition, Participating Provider will contact Organization to seek authorization for
additional care. If Organization does not return the call within 30 minutes, Participating
Provider is deemed to have been authorized to provide additional care required to treat
the Member. Notwithstanding any other provision in this Agreement, Organization shall
not deny payment for services provided by Participating Provider to Members in
accordance with EMT ALA.
6.5
Coordination of Benefits. Upon request, Participating Provider will give assistance to
Organization for purposes of coordinating benefits with primary carriers. If Organization
is the secondary carrier, Organization shall pay Participating Provider for Covered
Services that were not paid by the primary carrier. Payment by Organization to
Participating Provider will not exceed 100% of the Billed Charges.
6.6
Non-Covered
Services.
Subject to the exceptions provided for in Section 6.2,
Participating Provider agrees to accept the Discounted Charges as full compensation for
Covered Services provided hereunder. Participating Provider shall only bill and collect
from Members for Covered Services the applicable deductibles, coinsurance and/or
copayments under the Benefit Plan. Participating Provider may seek payment from the
Member, or persons acting on his or her behalf, in the amount of Participating Provider's
Billed Charges, in the event that Organization fails to make payment for Covered
Services pursuant to Section 6.2. Pmticipating Provider may bill Participating Provider's
Billed Charges for Services that are determined to be Non-Covered Services.
6.7
Underpayments
and Overpayments.
Participating Provider agrees to refund to
Organization and/or Member any amounts overpaid or paid in error, and Organization
agrees to promptly pay any underpayments to Participating Provider. Organization shall
notify Pmticipating Provider of any alleged overpayment, and shall not offset any such
amounts against amounts owed to Participating Provider unless agreed by Participating
Provider. No request for refund of overpayment will be accepted if the Payor does not
notify MMCI of the overpayment within three hundred sixty-five (365) days of the date of
the initial payment.
6.8
Claims Administration. Organization shall administer Benefit Plan claims in accordance
with U.S Depmtment of Labor regulations governing claims procedures for group health
plans, to the extent applicable to the Benefit Plan. If a Third Party Administrator (TPA) is
used for claims administration, the TPA shall be licensed by the State of Illinois as a TPA
and will produce a copy of the license upon request ofMFC. Company agrees to allow a
copy ofthis signed Agreement to be sent the designated TPA for loading of rates and
correct claims processing.
If a dispute develops, the parties will attempt to resolve the dispute. If the dispute cannot be
settled by the mutual cooperation ofthe parties, either party may, with thirty (30) day prior
written notice to the other party of its intent, refer the dispute to an independent arbitration
organization. Except as provided herein, any dispute, controversy, or claim arising out of
this Agreement including, but not limited to the payment or non-payment of a claim, the
eligibility of a Member, the determination of Covered Hospital Services, or the
determination of medically necessary procedures, shall be settled by arbitration in
accordance with this Section. Judgment upon the award rendered by the arbitrators may
be entered in any court having jurisdiction thereof. The place of arbitration shall be
Peoria, Illinois.
The arbitrators shall decide legal issues pertaining to the dispute,
controversy, or claim pursuant to the laws of the State of Illinois. Subject to the control
of the arbitrators, or as the parties may otherwise mutually agree, the parties shall have
the right to conduct reasonable discovery pursuant to the State of Illinois Rules of Civil
Procedure. The parties agree that this Agreement involves interstate commerce and is
therefore enforceable pursuant to Title 9, United States Code. The arbitrators shall have
no authority to award any punitive or exemplary damages, to vary or to ignore the terms
of this Agreement.
8.1
Entire Agreement. This Agreement together with all Attachments which are attached
hereto and made a part hereof, constitute the entire understanding of the parties to this
Agreement, and supersede all prior proposals, representations,
communications,
negotiations, and agreements between the parties whether oral or written.
8.2
Governing Law. This Agreement shall be governed by, interpreted in accordance with,
and the rights of the Parties shall be determined by the laws of the State of Illinois,
without regard to its conflict of law principles.
8.3
Venue. The Parties have executed and delivered this Agreement in Peoria, Illinois, and
stipulate that if either Party files litigation to construe, interpret, or enforce this
Agreement, Peoria County, Illinois is the proper and appropriate venue for such
litigation.
8.4
Counterparts. This Agreement may be executed in counterparts, and each executed
counterpati will be deemed to be an original version ofthis Agreement.
8.5
Attorney's Fees and Expenses.
If any arbitration or any other judicial proceeding is
necessary to enforce or interpret the terms of this Agreement, each party shall be
responsible for its own costs and expenses, including but not limited to attorney's fees.
Each party shall be responsible for an equal share of the mediators', arbitrators', and/or
administrative fees of mediation and/or arbitration associated with such an action.
8.6
Waiver of Breach. The failure of Organization or MFC to object to or to take affirmative
action with respect to any conduct of the other which is a breach of this Agreement shall
not be construed as a waiver of that breach or of any prior or future breaches of this
Agreement.
8.7
Severability. The provisions of this Agreement are independent of and separable from
each other, and no provision shall be affected or rendered invalid or unenforceable by
virtue of the fact that for any reason any other or others of them may be invalid or
unenforceable in whole or in part.
8.8
Binding Effect. This Agreement shall be binding upon, and shall inure to the benefit of,
the parties hereto and their successor and permitted assignees.
8.9
Headings. The section and other headings contained in this Agreement are for reference
purposes only and shall not affect in any way the meaning or interpretation of this
Agreement.
8.10
Independent Contractors. Each party to this Agreement is acting independently of the
other party, and none of the provisions of this Agreement may be construed as indicating
that either party is acting as the agent or employee of the other party.
8.11
No Third Party Beneficiaries. The parties to this Agreement are MFC and Organization.
No other person may claim or assert any rights under or by virtue of this Agreement.
This Agreement is not intended to, and does not, create any rights in any person,
including a Member, who is not a signatory to this Agreement.
8.12
Use of Name. Neither Organization nor MFC may use the other party's name, trademark,
service mark, or symbol without prior written consent of the other party.
8.13
Assignment. This Agreement or any of its provisions shall not be assigned, delegated, or
transferred by either party without the prior written consent of the other, provided that
MFC may assign, delegate, or transfer this Agreement upon notice to another corporation
or entity affiliated with MFC if (i) said corporation has the requisite power and authority
to perform the obligations of MFC set forth herein, and (ii) such assignment, delegation,
or transfer will not materially affect services to Members.
8.14
Amendment. No amendment to this Agreement shall be valid unless it is in writing and
signed by the parties.
8.15
Authority. Each party signing this Agreement represents that that party has properly
authorized such execution. The execution and performance of this Agreement by each
party has been authorized in compliance with all applicable laws and regulations, and this
Agreement constitutes the valid and enforceable obligation of the pmiies.
8. I 6
Notices. Any notices or other communications required
Agreement shall be in writing and delivered in anyone of
be deemed to have been received (a) on the date delivered
next following business day after being sent if sent
professional overnight courier, or (c) three (3) business
under the provisions of this
the following ways, and shall
if delivered by hand, (b) the
by a nationally recognized
days after mailing, postage
prepaid, by certified mail, return receipt requested, to the party entitled to notice at the
addresses set forth on the signature page, or such other addresses as may be directed by
notice given hereafter.
8.17
Quarterly Reports.
Organization agrees to provide quarterly reports to MFC which
identify specific utilization data by services, including but not limited to, the number of
Members, hospital admissions and provider visits and other reports mutually agreed to by
the parties.
8.18
Unforeseen Circumstances.
In the event Participating Provider does not have proper
facilities to treat Members or in the event of circumstances beyond its reasonable control
such as major disaster, epidemic, war, complete or partial destruction of facilities,
disability of a significant number of personnel, or significant labor disputes, Paliicipating
Provider shall provide Covered Services to Members to the extent possible according to
its best judgment or limitations of such facilities and personnel as are then available, but
neither Participating Provider or any of its agents, directors or officers shall have any
liability or obligation for delay or failure to provide or arrange for such services.
IN WITNESS
WHEREOF,
the parties hereto have executed this Agreement the day and year
as written below.
METHODIST FIRST CHOICE,
221 N. E. Glen Oak Ave
Peoria, IL 61636
REVl EWE D FOR
LEGAL SUFFICIENCY
MHSC
CO~~:~:A:~E
INe.
CITY OF EAST PEORA
100 S. Main Street
East Peoria, IL 61611
City of East Peoria
Exclusive
Methodist
EFFECTIVE
First Choice Rate Schedule
DATE:
CONTRACT
Inpatient Rates
May 1, 2012
TERM:
5 years
(except case rates as set forth below)
DRG Base Rate
Basic Payment = DRG Base Rate X Relative Weight Factor
Year 1
Years
2 through
$6,000
See Attachment B
5
Relative Weight Factor = The Relative weight as determined by the Center for Medicare and Medicaid Services
(CMS) and published in the Federal Register, updated yearly.
~'Outlier: For Inpatient services, if the Facility's regular billing rates for a Facility Stay are equal to or greater than 3 times the
calculated DRG rate (Outlier Threshold), the payor will payor aITange to pay Facility the calculated DRG rate and charges exceeding
the tiu'eshold discounted by 50%.
Bone Marrow
Transplant
DRG 016 & 017
$82,000
per case+
The BMT case rate is fr0111admission to discharge and does not include physician fees. The outpatient Pheresis line
placement and Harvesting will be subject to the 50% outpatient discOlmt.
+ If charges for any inpatient bone maITOWtransplant admission exceed $140,000, then tile payor will pay facility tile Case
rate and charges exceeding tile stop loss amolmt discOlmted by 50%.
Outpatient
services
will be discounted
by 50% off billed charges,
(except those listed as excluded)
Outpatient
psychiatric
Partial Hospitalization
discount:
psychiatric Per Diem:
Year 1
$469
Years 2 through 5
See Attachment B
Methodist First Choice Physician Network
Reimbursement will be based on the following:
130% of 2009 RBRVS for Pdmary Care Physicians
150% of 2009 RBRVS for Specialty Care Physicians
20% discountfor any code in which there is not an RBRVS fee available
Note: The majority of the First Choice providers will be based on the above Rates, however, there will be
some provider t'eimbursement based on various methods, including a discount off billed chatoges.
See the Methodist First Choice Provider Directmy online for a listing of participating providers at WI,j/W. mymethodist. net
Reimbursement will be the lesser of the fee schedule as outlined in the agreement or the prOVider's billed charges.
Varied Fee Schedules will be provided to the Payor to be reimbursed according to the provider's agreement with
Methodist First Choice, Inc.
Hospital Based Physicians
MDR values are based on the cun'ent year's release.
***These medical groups are independent physician providers not employed by Methodist Medical Center.
Group Name
Fee Schedule
***Emergency Physician Services
***Radiology Physician Services
***Peoria Tazewell Pathology Group
Anesthesiologists
Methodist Medical Group Hospitalists
20% discount off billed charges
60th percentile ofMDR
25% discount off billed charges
25% discOlmtoff billed charges
150% of2009 RBRVS
EXCLUSIONS TO CONTRACT DISCOUNTS
These services are not subject to any previously stated in or outpatient discounts.
Clinics and Services
Pain Clinic
_ DiscOlmtedrates listed above include MMCI based ambulatOlYoutpatient surgelYonly. Any other freestanding ambulatory
smgical center not afIiliated with Methodist Medical Center in Peoria, Tazewell and Woodford cOlmtieswithout consent of
Methodist First Choice are considered out of network or non-PPO. TIus will include but not linlited to Peoria Day SurgelY,
Great Plains Orthopaedics, Soderstrom Skin Institute and OSF Center for Health.
- New services developed by Methodist/First Choice during the tenll of the contract are not subject to the above discolmts.
Rates for new services will be negotiated separately.
- Inpatient and outpatient Hospital services are subject to periodic increases.
Abraham Lincoln Memorial Hospital
Lincoln, Illinois
Advocate BroMenn Medical Center
BroMenn Provider Network
Bloomington/Normal,
20% discount
10% discount
Illinois
DecatUl' Memorial
Decatur, Illinois
Advocate Eureka Hospital
Eureka, Illinois
Galesburg Cottage Hospital
Knoxcare Alliance Physicians
20% discount
20% discount
Galesburg, Illinois
Graham Hospital
Coleman Clinic Physicians
20% discount
150%/175% 0[2009 RBRVS
Canton, Illinois
Memorial Medical Center
Springfield,
Illinois
Hopedale Medical Foundation
Hopedale Health Network
Hopedale, Illinois
Pekin Hospital
Pekin, Illinois
St. Vincent Memorial Hospital
Taylorville, Illinois
20% discount
20% discount
ATTACHMENT A
Children's Memorial Hospital
30% discount
Chiidren'sMemorial
Faculty Practice Plan Physic 20% discount
Chicago, Illinois
Other hospitals that may participate in this agreement at the discount rates listed below.
Hammond-Henry
Hospital, Geneseo, IL
10% discount
36-6008003
Mason District Hospital, Havana, IL
10% discount
37-6017857
Mayo Clinic, Rochester, MN
Mercer County Hospital, Aledo, IL
5% discount
10% discount
41-6011702
36-6007544
Perry Memorial Hospital, Princeton, IL
10% discount
36-6006057
Skilled Nursing
Psychiatric Nmsing
Social Work
Home Health Aid
Physical Therapy
Occupational Therapy
Speech Therapy
-Available 24 homs a day, 7 days a week, including a second shift staff.
-Price includes travel time portal to portal, direct patient contact time and doclU11entation time.
-Any pOliion of time over a two-hour minimlU11, but less than four hours, will be charged as two visits.
-Non-routine supplies subject to a 15% discount off charges.
-Serving clients in Peoria, Woodford, Tazewell, Fulton, Knox, Stark, Putnam, Mason, & Marshall cOlmties.
-Occupational Therapy includes the services of an OT and OTA supervised by the OT.
-Physical Therapy includes the services ofa PT and a PTA supervised by the PI.
Routine Care rate includes all of the fol101ving diciplines:
Registered Nurse
Social Worker
Pastoral Care
Home Care Aide
Home Medical Equipment
Oral Medications specific to pain control
Other Hospice services available at the 15% discount:
Continuous Care
Respite Care
General Inpatient Care
Methodist Medical Center of Illinois
Genera/Information
221 NE Glen Oak Ave
Peoria, IL 61636
(309) 672-4848
MMCI Business Office
7181 Reliable Pkwy.
Chicago, IL 60686
Methodist Medical Center oflllinois,
Home Health
120 NE Glen Oak Ave
Ste 200
Peoria, IL 61603
309-671-8247
Fax (309) 671-2743
MMCI Home Health
6220 Reliable Parkway
Chicago, IL 60686
Methodist Medical Center oflllinois,
Hospice Services
120 NE Glen Oak Ave
Ste 200
Peoria, IL 61603
309-672-5746
Fax: (309) 671-2168
MMCI Hospice
6210 Reliable Parkway
Chicago, IL 60686
HOSPITAL will receive an annual rate adjustment
of 2% per measure below, for a total increase of 4%
maximum, to the DRG Base Rates and Per Diems if HOSPITAL meets the following measures.
•
Hospital's
Inpatient and Outpatient
Satisfaction Scores, for all payer data, combined average is
above the 85th percentile for Press Ganey
u.s.
Hospitals, using the most recent 12 month
average, a 2% increase will be given to the Hospital.
•
Hospital's Mortality
Index is less than or equal to .95 based upon the most recent 12 month
average as reported by Hospital using Premier, Inc. benchmark data (based upon all payer data)
a 2% increase will be given to the Hospital.
TERM:
Organization has the option of using the Initiative during any, some, or all of the
Agreement's Terms. MFC may tenninate the Initiative, should Organization breach any tenns
related thereto.
MFC's Health and Wellness Improvement Initiative (the "Initiative") is a voluntary program.
Organization is not required to participate in the Initiative. If Organization participates in the
Initiative, MFC shall reimburse Organization up to $75 per covered employee per year for
qualified health and wellness initiatives, up to a total of $30,000, submitted to MFC for
reimbursement pursuant to this Addendum.
•
Employee HealthlWellness
Screenings
performed by the Methodist Wellmobile,
Optimum Health Solutions, or any other preventative screening provider approved by MFC
in writing prior to the screening.
•
ExerciselFitness
Programs through a membership at the Methodist Wellness Center,
participation in Methodist Wellness Center Group Fitness Classes or a membership at
Eastside Center.
•
Smoking Cessation through an established program by the American Lung Association,
the Peoria City/County Health Department, or other programs as approved by MFC in
writing prior to commencing the program; nicotine replacement therapy (such as gum,
lozenges, patches, or inhalers); or prescription medication.
•
Diet and Nutrition through participation in an established program by Methodist Medical
Center, Weight Watchers, Nutrisystem, Jenny Craig, Seattle Sutton, or other weight loss
programs approved by MFC in writing prior to commencing the program; obesity/weight
loss consultation and treatment or nutritional consultation at the Methodist Center for
Integrative Medicine; or Nutritional Products from Methodist Healthy Solutions.
MFC shall only reimburse Organization for qualified health and wellness initiatives accompanied
by acceptable documentation thereof. If Organization desires reimbursement, it shall submit a
request for reimbursement bi-annually of each term year. The request for reimbursement shall
list the total amount of reimbursement sought, the name of each covered employee for which
reimbursement is sought, and the amount of reimbursement sought for each covered employee.
The request for reimbursement shall attach proof of payment for each initiative. Acceptable
proof of payment shall consist of a receipt or similar documentation from the third party vendor,
number of covered employees served, description of the services provided, and dollar amount
charged for the services provided.
Any misrepresentations contained in a request for reimbursement shall constitute a material
breach of the Agreement and be grounds for MFC's termination of the Initiative for the remainder
of the Agreement's Term, pursuant to Section 2.3 of the Agreement.
16
ORDINANCE NO. 4033
AN ORDINANCE AMENDING THE SIGN CODE FOUND AT
TITLE 4, CHAPTER 7 OF THE EAST PEORIA CITY CODE FOR THE
PURPOSE OF AUTHORIZING CERTAIN SPECIAL OFF-PREMISES SIGNS
WHEREAS, the City has entered into an agreement for the development of a
Target store and additional retail facilities in the New EP Downtown Project Area located in
the West Washington Street TIF District; and
WHEREAS, the City has also entered into an agreement for the development of a
Costco store in the New EP Downtown Project Area located in the West Washington
Street TIF District; and
WHEREAS, three separate off-premises signs (the “Special Off-Premises Signs”)
are necessary to promote retail development in the New EP Downtown Project Area
including the Target and Costco stores; and
WHEREAS, placement of the Special Off-Premises Signs at the hereinafter
indicated locations in accordance with the hereinafter established specifications will not
adversely affect property or businesses adjacent to the Special Off-Premises Signs and
will not otherwise adversely affect the general public; and
WHEREAS, placement of the Special Off-Premises Signs at the desired
locations will require amendment of the Sign Code in the manner hereafter set forth;
NOW, THEREFORE, BE IT ORDAINED BY THE COUNCIL OF THE CITY OF
Section 1. Title 4, Chapter 7, Section 7 of the East Peoria City Code is hereby
amended by the addition thereto of a new subsection (g) which shall read as follows:
(g)
Permitted Special Off-Premises Signs. Any other provisions
of the City Code to the contrary notwithstanding, special offpremises signs may be placed at the following locations and
constructed in accordance with the following specifications:
(1)
One sign may be placed on property located to the
southwest of Camp Street between the Camp Street
right-of-way and the Farm Creek channel and located
to the southeast of Clock Tower Drive right-of way
within a distance of and not more than one hundred
(100) feet from the Clock Tower Drive right-of way
(being the intersection of Clock Tower Drive and
Camp Street);
(2)
southwest of Camp Street between the Camp Street
right-of-way and the Farm Creek channel and located
to the southeast of Altorfer Drive right-of way within a
distance of and not more than one hundred (100) feet
from the Altorfer Drive right-of way (being the
intersection of Altorfer Drive and Camp Street); and
(3)
southwest of the Interstate 74 right-of-way along the
northwest side of Altorfer Drive within a distance of
and not more than one hundred ten (110) feet from
the Interstate 74 right-of way.
(4)
The special off-premises signs authorized by this
subsection (g) shall be subject to the following
specifications and restrictions:
a.
The area of each such sign shall not exceed
four hundred (400) square feet.
b.
The height of each such sign shall not exceed
seventy (70) feet.
c.
Such signs may be double-faced.
d.
Such signs shall advertise only retailers
operating within the Target Area Business
District designated by Ordinance No. 4022
and/or the Costco Area Business District
designated by Ordinance No. 4024.
e.
The design of each such sign must be
approved by the City’s Design Review
Committee.
Section 2. This Ordinance is hereby ordered to be published in pamphlet form
by the East Peoria City Clerk and said Clerk is ordered to keep at least three (3) copies
hereof available for public inspection in the future and in accordance with the Illinois
Municipal Code.
Section 3. This Ordinance is in addition to all other ordinances on the subject
and shall be construed therewith excepting as to that part in direct conflict with any other
ordinance, and in the event of such conflict, the provisions hereof shall govern.
2
Section 4. This Ordinance shall be in full force and effect from and after its
passage, approval and ten (10) day period of publication in the manner provided by law.
PASSED BY THE COUNCIL OF THE CITY OF EAST PEORIA, TAZEWELL
COUNTY, ILLINOIS, IN REGULAR AND PUBLIC SESSION THIS
DAY OF
_________________, 2012.
APPROVED:
________________________________
Mayor
ATTEST:
________________________________
City Clerk
EXAMINED AND APPROVED:
________________________________
Corporation Counsel
3
, 2012
WHEREAS, the City Clerk is from time to time temporarily absent from City Hall
and, therefore, unable to perform the duties assigned to the City Clerk; and
WHEREAS, in order to allow performance of the duties assigned to the City
Clerk when the City Clerk is absent, it is in the best interests of the City to appoint two
employees of the City to serve as Deputy Clerks;
EAST PEORIA, TAZEWELL COUNTY, ILLINOIS, THAT J. Thomas Brimberry and Jill
Peterson are hereby appointed as Deputy City Clerks with authority to fulfill the duties
and responsibilities of the City Clerk when the City Clerk is absent.
APPROVED:
________________________________
Mayor
ATTEST:
__________________________________
City Clerk
________________, 2012
WHEREAS, the City and the Fondulac Park District have each agreed to
contribute $500,000 toward the cost of roadway improvements to Fondulac Drive (the
“Project”); and
WHEREAS, the following contractors have agreed to perform the hereinafter
described work in connection with the Project at the indicated cost:
Contractor
Description of Work
Contract Amount
P.A. Atherton
ICCI
Hoerr Construction
Erosion stabilization
$108,500.00
Curb to eliminate ponding water
73,920.00
Slip lining of drainage pipes
164,970.00
EAST PEORIA, TAZEWELL COUNTY, ILLINOIS, THAT the City Administrator or his
designee is hereby authorized and directed to enter into contracts in such form as the
Mayor in his discretion may approve with the aforementioned contractors to perform the
described work at the indicated cost; provided, however, that the City shall have no
obligation under the terms of this resolution until executed originals of such contracts
have been delivered to the respective contractors.
APPROVED:
_________________________________
Mayor
ATTEST:
_______________________________
City Clerk
, 2012
FOR TRAFFIC SIGNALS IN NEW EP DOWNTOWN
in the EP Downtown Development Project Area to Costco upon which Costco will construct
and operate a Costco wholesale and retail general merchandise facility with related
amenities; and
WHEREAS, based upon to the agreement with Costco, the City has re-designed the
traffic entrance into the Costco Site off of West Washington Street (the re-aligned West
Washington Street from the Technology Boulevard construction project) to accommodate
traffic flow into the Costco Site; and
WHEREAS, the re-designed traffic entrance into the Costco Site will be a new
intersection between the newly re-aligned West Washington Street and the Altorfer Drive
Extension, which will require traffic signals and related electrical work (the “Traffic Signal
Project”); and
WHEREAS, in an effort to prepare the roadway infrastructure for providing access to
the Costco Site, the City has sought bids for the construction of the Traffic Signal Project;
and
contract for the Traffic Signal Project to Laser Electric (the “Contractor”);
Section 2. Laser Electric is awarded the contract for the Traffic Signal Project for
the Costco development project.
Agreement for the Traffic Signal Project with the Contractor (Exhibit A) on behalf of the
City, together with such changes therein as the Mayor in his discretion deems appropriate,
at a total cost not to exceed $291,071.10 for the Agreement; provided, however, that the
City shall have no obligation under the Agreement with the Contractor until such time as an
executed original of such documentation has been delivered to the Contractor.
APPROVED:
_________________________________
Mayor
ATTEST:
__________________________________
City Clerk
2
________________, 2012
WHEREAS, the Department of Public Works has heretofore solicited proposals for
various components of the 2012 Street Maintenance Program (the “Project”); and
WHEREAS, the following contractors have agreed to perform the hereinafter
described work in connection with the Project at the indicated cost:
Contractor
P.A. Atherton
R.A. Cullinan & Son, Inc.
American Asphalt Recycling,
Inc.
Ace in the Hole, Inc.
Description of Work
Drainage
Sealcoating
Heat Scarification
Spray Patching
Contract Amount
66,338.00
391,849.32
267,245.50
63,560.00
described work at the indicated cost; provided, however, that the City shall have no
obligation under the terms of this resolution until executed originals of such contracts have
been delivered to the respective contractors.
APPROVED:
_________________________________
Mayor
ATTEST:
_______________________________
City Clerk
MEMORANDUM
TO:
Mayor David W. Mingus and Members of the City Council
THRU:
Tom Brimberry, City Administrator
FROM:
City Attorney’s Office
SUBJECT:
Purchase of Equipment and Services for Telecommunications Upgrade
DISCUSSION: The Police Department has received proposals from various vendors to provide the City
with all necessary equipment and installation services necessary to complete the first step of upgrading
the Telecommunications Center at the cost of $352,655. Funds from the Technology Grant will be
applied to this project in the amount of $235,440. This leaves a balance needed from gaming of
$117,215. The Police Department negotiated with various suppliers of the necessary equipment and
services to secure the lowest available price. This expenditure is included in the current budget. This
first step of the Telecommunications Center Upgrade is $12,785 under budget.
RECOMMENDATION:
Approve
________________, 2012
WHEREAS, the Police Department proposes to upgrade the telecommunications
center (the “Project”); and
WHEREAS, the following contractors have agreed to provide the hereinafter
described equipment in connection with the Project at the indicated cost:
Contractor
Description of Equipment
Ragan Communications, Inc.
Console Equipment and
911 Phone System
including shipping
R.K. Dixon
Upgraded copy machine
with scanning capability
Emergency
System Board
Telephone Six Monitors
Contract Amount
333,445.00
15,499.00
3,711.00
described work and provide the described equipment at the indicated cost; provided,
however, that the City shall have no obligation under the terms of this resolution until
executed originals of such contracts have been delivered to the respective contractors.
APPROVED:
________________________________
Mayor
ATTEST:
_______________________________
City Clerk
Ragan Communications Inc.
Invoice
Phone: 309-745-9386
Fax: 309-745-3215
2 Ragan Court
Washington, IL 61571
Number:
5864
Date:
3/12/2012
Source:
Bill-To
EAST PEORIA POLICE DEPARTMENT
201 E WASHINGTON ST
EAST PEORIA, IL 61611 U.S.A.
Acct. No.
NR Cust. No.
Acct. ID
713
EAS107
EAS107
Customer
so
No. 6456
Ship-To
EAST PEORIA POLICE
DEPARTMENT
201 E WASHINGTON ST
EAST PEORIA, IL 61611 U.S.A.
PO
Reference
Sales Reo
Shin Via
Terms
RAGAN
COMMUNICATIONS
Net 30
EQUIPMENT INVOICED PER FINAL QUOTES DATED 3/02/2012 LABELED "3 POSITION INTEGRA TOR RD
(RADIO) AND ''EP PSAP 3 POSITION INTEGRA TOR 911 PHONES"
INVOICE IS LESS FREIGHT. FREIGHT WILL BE INVOICED AT ACTUAL.
DOES NOT INCLUDE FURNITURE
Qty. Item ID
Description
1.00
ZETRON INTEGRATOR
MISCELLANEOUS
UOM
PER ATTACHED
1.00
MISCELLANEOUS
INTEGRATOR
ATTACHED
CONSOLE EQUIPMENT
Ea. Price
Total
EA
$182,025.00
$182,025.00
EA
$149,720.00
$149,720.00
QUOTE
911 PHONE SYSTEM PER
QUOTE
Item
Total:
Total Amount Due:
$331,745.00
$331,745.00
(* denotes repair item)
invoice.rpt
Printed: 3/12/2012
5:1l:25PM
Page 1
(zETRONl
SERIES 4000 COMMUNICATIONS
US QUOTE I ORDER FORM
PO# I QUOTE#
FINAL PROPOSAL
Date:
3/02/2012
CITY OF EAST PEORIA
201 W WASHINGTON STREET
EAST PEORIA, IL 61611
SHAWNA MANGOLD
(309) 698-4700
Company:
Address:
EndUserlSite: EP PSAP
Sys ID: INTEGRATOR RD
Cust. #:
Quote Expires:
Terms: To be determined
Ship Quote*: 8 Weeks ARO
Ship Via: UPS-FOB Oriqin
Cust Ref: 13 POSITJON INTEGRATOR RD (RADIO)
Salesperson: RAGAN COMMUNICATIONS - NEAL RAGAN
Contact:
Phone:
Fax:
Email: shawnamangold@cityofeastpeoria.com
This quote
Summa~:
CONTROL SYSTEMS
IS
valid for 120 days from quote date.
~
~
DESCRIPTION
RACKMOUNT OPERATOR POSITION COMPONENTS (CONVENTIONAL BUTTON/LED)
901-9233
802-0092
709-7270
Model 27 Monitor Speaker Panel
Power Supply (M4118 or M27)
Power Supply Adapter Cable (M27)
PC-BASED OPERATOR POSITIONS AND COMPONENTS
IntegratorRD
905-0178
v4 with M4217 Audio
Panel
IntegratorRD Radio Dispatch Workstation Version 4
Includes PC with Windows IntegratorRD software, M4217B Audio Panel, Radio
Dispatch Programming
(ROPS) software, power supply, three-button mouse,
installation manual, and Software COROM & License. Monitor not included.
INSTANT RECALL RECORDER
905-0247
IntegratorlRR Package (license required 930-0048 below)
Includes IntegratorlRR
included.
950-0833
COROM and radio/telephone
interface.
Speakers
not
Game Port to USB adapter for Contact Closure
OPERATOR POSITION SOFTWARE OPTIONS
930-0026
IntegratorRD Extended Paging Package
OPERATOR ACCESSORIES
950-9459
950-9439
709-7350
950-9102
905-0325
Gooseneck Microphone (for M4118, 4217B)
Telephone/Radio Headset Interface (TRHI)(for all models)
Dual TRHI Connector
Footswitch
S4000 Monitor AlB Speaker Kit
FOR ADDITIONAL
ACCESSORIES
SEE COMPANION
PRODUCTS
SECTION
COMMON CONTROL EQUIPMENT
905-0156
M4048 Redundant System Bundle
One each of: Console Interface
Card Cage, and Channel
Two each of: Power Supply, and System
Interface
Card Cage
Traffic Card
RADIO CHANNEL CARDS
950-9820
Dual Channel Tone/Local T/R Control Card
NOTE: If in doubt, order PIN 709-7452, S4000 Channel RS-232
sending any of the above cards to older systems.
RADIO CHANNEL CARDS-lntegratorRD
950-9867
950-9868
Operations
Cable when
Only
M/A-COM (GE/Ericsson) Wireless Dual Channel T/R Card
(Orion, 500M Jaguar, M7100 mobiles)
M/A-COM (GE/Ericsson) Wireless Interface Module (Orion,
500M Jaguar, M7100 mobiles)
CONTROL AND ADAPTER CARDS
950-0293
950-9695
905-0229
Auxiliary Input/Output Interface Card
Console Interface Card (M4020/4048 only) (1 Per Position)
Model 4020/4048 8 Patch Card
001-0055_AT
4/09
All trademarks are properties of their respective owners.
Please refer to the Price Book for Zetron's Terms and Conditions
Page 1 of 2
COMMON
CONTROLLER
930-0052
OPTIONS
Channel Check -- Instant Recall Recorder Software Option
Note: 1per Dual Channel Universal or Tone/Local Control Card. This option
requires PIN 950-9951, S4000 Dual Channel Memory Option.
950-9951
S4000 Dual Channel Memory Option (needed for TX voice delay and
MDC/GSTAR squelch)
Note: 1per Dual Channel Universal or Tone/Local Control Card
950-0078
M4048 Radio System Management Program
INSTALLATION
709-0004
950-9351
950-9199
COMPONENTS
o
25-Pair Cables, RJ-21, M-F, 10ft [Baseline Product]
Connectorized Punchdown Block [Baseline Product]
Connectorized Punchdown Block (Protected) [Baseline Product]
~
20
2
UPGRADES
Console Firmware Upgrades
950-0511
M4217/M4219 Firmware
Control and Adapter Card Firmware Upgrades
950-0186
Dual Channel Universal & Tone/Local Firmware
950-0189
Auxiliary I/O Card Firmware
COMPANION PRODUCTS [all are Baseline Products]
COMPUTER
PC CARDS
802-5304
2-Port (DUAL DVI or VGA) PCI Express Video Card, 128 MB
COMPUTER KEYBOARDS & POINTER DEVICES
950-9447
Three-Button Trackball
950-0197
Compact PC Keyboard w/ Mini PS/2 DIN Connector
COMPUTER AUDIO DEVICES
802-5006
IRR Multi-media Desktop PC Speakers
RACKS & CABINETS
The Model 4020 and M4048 require a rack or cabinet for mounting.
950-0083
19" W x 77" (44U) H x 23" D Rack
MISCELLANEOUS
19" TOUCH SCREEN MONITOR BLACK (ETSB)
CAT5 CABLE, CONNECTORS, LABELS, ETC
MISC
LABOR TO INSTALL ABOVE
LABOR
IimIilI3
S4000 Products
Baseline & Misc. Products
Total 4000 Products
$
Total Baseline & Misc. Prod.
$
149,745.00
32,280.00
TOTAL ALL PRODUCTS $
TOTAL INSTALLED PRICE $
182,025.00
182,025.00
Shipping is Additional
NOTES:
*Ship date subject to change based upon availability of materials and volume of other orders at time of order. Firm ship date
will be confirmed after receipt of order.
ADDITIONAL NOTE:
This price quote and any related orders subject to Zetron's Terms & Conditions (# 001-0136).
001-0055_AT
4109
All trademarks are properties of their respective owners.
Please refer to the Price Book for Zetron's Terms and Conditions
Page 2 of 2
(ZETRONl
PO# I QUOTE#
SERIES 3200 E9-1-1 TELEPHONE SYSTEM
FINAL PROPOSAL
US QUOTE I ORDER FORM
3/02/2012
Sys II INTEGRATOR 911
Date:
Company:
Address:
Contact:
CITY OF EAST PEORIA
201 W WASHINGTON STREET
EAST PEORIA, IL 61611
SHAWNA MANGOLD
Phone: 309 698-4700
Fax:~
~~~~
__ ~ __ ~
Email: shawnamangold@cityofeastpeoria.com
-i
This quote
Summa~:
IS
valid for
~I
120 days
from quote date.
~
QTI
DESCRIPTION
INTEGRATOR
950-1046
950-0459
RACKMOUNT
901-9561
RACKMOUNT
950-9420
SUITE SOFTWARE
Integrator Reporting System
Integrator Telephony Suite CD ROM
911 CONSOLES
3230R 30 Key Rackmount
911 CONSOLE ACCESSORIES
20 Key Module
~
CD
i
950-9650
Handset w/ Cord
CONSOLE OPTIONS
950-9689
Alias Dial
950-9690
TDO Option
STATION CARD SHELVES & STATION CARDS & VolP
901-9534
Primary Station Card Shelf
950-9948
Primary Station Card
950-0220
Conference Station Card
All CONTROLLER & OPTIONS
950-0102
Controller Card Slot Cover
950-0112
CDR Printer
LINE CARD SHELVES & LINE CARDS
950-0079
Line Card Shelf
950-9831
AC Interrupter Card
950-0848
S3200 Advanced E9-1-1 Trunk Card
950-0847
S3200 Advanced Caller 10 Line Card
950-9833
Basic Line Card
POWER SUPPLIES
950-9961
AC Sig/Lamp/Ring Supply
950-0110
AC Talk Supply (-48 VOC)
CABLING AND INSTALLATION
709-0004
CO/PBX Cable [Baseline Product]
950-9351
CO/PBX Punch Block [Baseline Product]
950-9962
Protected CO Punch Block [Baseline Product]
950-0099
E9-1-1 Programming System
950-0447
Secondary/Conference Station Card Firmware Update
COMPUTERS
950-0601
Windows XP Pro Workstation PC, Dell Optiplex
COMPUTER PC CARDS
802-0435
RS-232 Serial Port Card, 2 Port
COMPUTER NETWORK
802-0331
8-Port Ethernet Hub
COMPUTER SOFTWARE
950-1048
*Microsoft SQL 2008 Server w/10 CALs
UN INTERRUPTIBLE POWER SUPPLIES (UPSs)
802-0329
1425 VA Desktop UPS
RACKS & CABINETS
Rackmount PCs and UPSs require 4-post installation in 29" or deeper cabinets
950-0083
19" W x 77" (44U) H x 23" D Rack
802-0370
Rackmount, 12-outlet, 120 V Power Strip
SPARES
001-0176_AF
4/09
All trademarks
are properties
of their respective
owners.
Please
refer to the Price Book for Zetron's
EE
~
~
I
EE
m
IT]
IT]
IT]
o:J
EE
Terms
and Conditions
Page 1 of 2
OPERATOR
905-0303
POSITION BUNDLES
9-1-1 Operator, 3-Position Bundle
Includes: 3 Integrator 911 clients, 3 Integrator IRR, 19-1-1 Server License, 1 Station Card Shelf, 3
Station Cards, 4 ctt Cables, 1 EX E9-1-1 Controller with ALl, 2 Line Card Shelves, 3 E9-1-1 Trunk
Cards, 1 Alarm Monitor Assy, 2 Rack Dist Cables, shelf blanks, and manuals
MISCELLANEOUS
19" TQlLCH SCREEN MONITOR BLACK (ETSB)
CAT5 CABLE, CONNECTORS, LABELS, ETC
MISC
LABOR TO INSTALL ABOVE
LABOR
'i'P"'h',·:t
Series 3200 Products
Baseline & Miscellaneous
Total 3200 Products
Products
Total Baseline & Mise Prod.
$
$
125,860.00
23,860.00
TOTALALLPRODUCTS-$~--~1~49~,~72~0~.0
items in red removed from quote
items in yellow reflect a change or addition
TOTAL INSTALLED
PRICE
$
149,720.00
=========
Shipping
NOTES:
*Ship date subject to change based upon availability of materials and volume of other orders at time of order.
after receipt of order.
Additional Note:
This price quote and any related orders subject to Zetron's Terms & Conditions (#001-0136).
001-0176_AF
4/09
All trademarks
are properties of their respective owners.
Please refer to the Price Book for
Zenon's
Terms and Conditions
is Additional
Firm ship date will be confirmec
Page 2 of 2
rkdix
Everything just runs better"
COPIERS. PRINTERS· NETWORKS
R.K.Dixon Proposal for
City of East Peoria Police Department
Details
Purchase Price
Xerox 5790PT
Xerox 5775PT
Xerox 5765PT
All Three
Systems with
Finishers and
3 Hole Punch
$14,640.00
$13,671.00
$12,797.00
Network Scanning
(Optional)
Scan to Folder
Scan to e-mail
$859.00
.
Fax:
$313.00
$743.00
One Line
'"1'1.
T •
TOTAL CARE SERVICE PLAN
INCLUDES PARTS, LABOR AND SUPPLIES
PAPER AND STAPLES ARE NOT INCLUDED
Service would still be covered under the Blanket Service
Agreement that We Currently Have With the City of East
Peoria
The options may be added at a later date
3/28/2012
Jeffery S. Redmon
RKDixon
(309) 657-0709
(309) 692-3300
DATE
Quote Valid for 30 Days
2012 Telecommunications Center
Upgrade Cost Analysis
Series 4000 Communications Control System.………………$182,025
Series 3200 E9-1-1 Telephone System……………………….$149,720
Shipping…………………………………………………………..$1,700
Monitors (6 purchased Directly Through ETSB)……………..$3,711
Upgrade Copy Machine(6 years old)Xerox 5790PT…………$15,499
Total……..……………..$352,655
Technology Grant…….$235,440
-----------------------------------------------------
Total Needed From Gaming
**$12,785 Under Budget**
$117,215

04.03.2012 Agenda Packet

Transcription

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