HomeMy WebLinkAboutContract 47547-A1 CITY SECRETARY
FIRST AMENDMENT AND FIRST RENEWALNTRACT N0.
OF FORT WORTH CITY SECRETARY
ccs CONTRACT NO. 47547
This First Amendment and First Renewal ("AMENDMENT") of Fort Worth City
Secretary Contract No. 47547 ("AGREEMENT") is made and entered into by and between the
City of Fort Worth, a home-rule municipal corporation of the State of Texas ("City"), acting
herein by and through Susan Alanis, its duly authorized Assistant City Manager, and Aetna
Behavioral Health, LLC ("Consultant"), a Corporation, acting herein by and through Hyong Un,
M.D., its duly authorized Head of Employee Assistance Programs and Chief Psychiatric Officer.
. City and Consultant are individually referred to as a "Party" and collectively referred to as the
"Parties".
WHEREAS, City and Consultant are currently Parties to the Agreement for Consultant
to provide Employee Assistance Program (EAP) services to City; and
WHEREAS, the Agreement provides for a three (3)-year initial term with options for up
to two, one-year renewal terms, the initial term beginning on January 1, 2016 and ending on
December 31, 2018; and
WHEREAS,the Parties wish to amend the Agreement to reflect a new Service and Fee
Schedule for the first and second renewal periods; and
WHEREAS,the Parties mutually agree to renew the Agreement for the first renewal
period which will begin on January 1, 2019 and end on December 31, 2019 (the "First
Renewal").
NOW THEREFORE, KNOWN ALL BY THESE PRESENT, City and Consultant, acting
herein by and through their duly authorized representatives, enter into this Amendment, which
amends the Agreement as follows:
1.
The Agreement is hereby amended by replacing the "DOMESTIC EAP SERVICE AND
FEE SCHEDULE" of the Agreement in its entirety with the attached Exhibit A to this
Amendment for the optional first and second renewal periods.
2.
City and Consultant mutually agree to renew CSC No. 47547 for an additional one year
period, which will begin January 1, 2019 and will end on December 31, 2019.
3.
Except as expressly modified in this Amendment, all other terms and conditions of the
Agreement shall remain in full force and effect.
FIRST AMENDMENT AND FIRST RENEWAL
OF CSC NO.47547 Page 1 of 8
IN WITNESS WHEREOF, the said parti5s have hereto set their hands and seal of office
to triplicate originals on this %qday of --. , 2018.
CITY: CONTRACTOR:
CITY OF FORT WORTH AETNA BEHAVIORAL HEALTH LLC
APPROVED:
By: C'(v M J. mos
'oil- Name: SusanAlanis By:
Title: Assistant City Manager Name: Hyong Un, M.D.
Title: Head of EAP and Chief Psychiatric
APPROVED AS TO FORM AND Officer
LEGALITY:
By:
Name: Thomas Royce Hansen
Title: Assistant City Attorney
Contract Authorization: M&C
v :c -)-I {
ATTESTED: " ®X�Q�T
�
By:—7L
Name: Maryay r
Title: City Sec tary TES t`
Contract Compliance Manager:
By signing I acknowledge that I am the
person responsible
For the monitoring and administration of this
contract, including
Ensuring all performance and reporting
requirements.
L- ill
Vicki Tieszen,MPcj, CHP 0111CIAL RECORD
Wellness/EAP Manager
CITY SECRETARY
F7 17.!-IRTH,TY
FIRST AMENDMENT AND FIRST RENEWAL
OF CSC NO.47547 Page 2 of 8
EXHIBIT A
DOMESTIC EAP SERVICE AND FEE SCHEDULE
Customer hereby elects to receive the Services, within the 50 U.S. states only, as designated below. The below
Service Fees shall be in effect for three(3)years beginning upon the Effective Date of this Services Agreement,and,
thereafter, if this Services Agreement is extended by the parties for any additional successive one year term(s), such
Service Fees may be revised for each such successive term. Notwithstanding the immediately preceding sentence,
the below Service Fees shall be amended by Company, from time to time during the first two (2) years of this
Services Agreement and for any future period(s) thereafter, in accordance with the terms of this Service and Fee
Schedule.
Services Service Fees
EAP Session Model
Unlimited Telephonic Access $1.44—Year One
$1.49—Year Two
with
Up to six(6)counseling sessions with
an EAP Network Provider or televideo
provider,delivered via face-to-face,
telephonically,or televideo per problem
per contract year
Worklife Services,including Caregiving Included in the EAP Session Model PE/PM.
Services, Personal Services,Legal and
Financial Services,Identity Theft Services,
Core Member Website
Intake Model
Clinical First Model Included in the EAP Session Model PE/PM.
FIRST AMENDMENT AND FIRST RENEWAL
OF CSC NO.47547—Exhibit A Page 3 of 8
Services Service Fees
Critical Incident Support/Critical Incident Bank of Standard CISD Hours: Five(5)hours of standard
Stress De-Briefing(CISD)Services— CISD services are included in the EAP Session Model PE/PM
Standard Services(On-site attendance Rate.Any additional standard CISD sessions are$250.00 per
response time in greater than 2 hours) hour plus travel and preparation expenses reimbursed at a flat
rate of$150.00 per location. Immediate CISD's are subject to
the fees described below.
CISD hours used,whether fee for service and/or within the bank
of standard hours,are calculated based upon the combined total
number of hours all clinicians are on-site.
If Customer requests a specific crisis counselor,or a counselor
with specific qualities, including but not limited to specialized
certifications,experience,or language,Customer will be billed
the applicable hourly rate"door-to-door"which will include the
specialist's travel time. This is in lieu of the flat travel fee.
If Customer requests on-site crisis response services in a
location which is further than 50 miles from a town with a
population of at least 25,000 people,Customer will be billed the
applicable hourly rate"door-to-door"which will include the
specialist's travel time. This is in lieu of the flat travel fee.
If Customer requests on-site support services in response to a
large scale disaster area affecting the transportation
infrastructure of that area,and/or the availability of local
providers,necessitating the assistance of providers from outside
the affected areas,Customer will be billed the current hourly
rate plus$50 per hour for each on-site hour. In addition,
Customer will be billed$200 per travel hour from the command
center to the intervention site. This is in lieu of the flat travel
fee.
Any other Customer requested services wherein the crisis
counselor incurs non-standard travel(e.g.having to fly to
accompany employees affected by a crisis)will be billed at the
exact travel costs in addition to the hourly fees.
Critical Incident Support/Critical Incident Fee for Service Immediate CISD Pricing: $350.00 per hour
Stress De-Briefing(CISD)Services— plus travel and preparation expenses reimbursed at a flat rate of
Immediate Services(On-site attendance $150.00 per location.
response time in 2 hours or less)
CISD hours used,whether fee for service and/or within the bank
of standard hours,are calculated based upon the combined total
number of hours all clinicians are on-site.
If Customer requests a specific crisis counselor,or a counselor
with specific qualities,including but not limited to specialized
certifications,experience,or language,Customer will be billed
the applicable hourly rate"door-to-door"which will include the
specialist's travel time. This is in lieu of the flat travel fee.
FIRST AMENDMENT AND FIRST RENEWAL
OF CSC NO.47547-Exhibit A Page 4 of 8
Services Service Fees
If Customer requests on-site crisis response services in a
location which is further than 50 miles from a town with a
population of at least 25,000 people,Customer will be billed the
applicable hourly rate"door-to-door"which will include the
specialist's travel time. This is in lieu of the flat travel fee.
If Customer requests on-site support services in response to a
large scale disaster area affecting the transportation
infrastructure of that area,and/or the availability of local
providers,necessitating the assistance of providers from outside
the affected areas,Customer will be billed the current hourly
rate plus$50 per hour for each on-site hour. In addition,
Customer will be billed$200 per travel hour from the command
center to the intervention site. This is in lieu of the flat travel
fee.
Any other Customer requested services wherein the crisis
counselor incurs non-standard travel(e.g.having to fly to
accompany employees affected by a crisis)will be billed at the
exact travel costs in addition to the hourly fees.
Critical Incident Support/Critical Incident Whenever possible,Customer agrees to provide Company with
Stress De-Briefing(CISD)Cancellation Fee 24 hours advance notice of cancellation of any requested
Workplace Crisis Response Services. Failure to provide
Company with 24 hours'notice of cancellation of any services:
• Fee for Service CISD Cancellation Fee: Services
which are provided on a fee for service basis and which
are subject to the hourly rate will result in a charge of
$375.00 per incident.
• Bank of Standard CISD Hours Cancellation Fee:
Services which are included in the bank of capitated
hours described above, will result in the deduction of a
number of hours from the bank,equal to the number of
cancelled hours.
Reduction in Force Fee for Service Reduction in Force Pricing: $250.00 per hour
plus travel and preparation expenses reimbursed at a flat rate of
$150.00 per location.
Reduction in Force Cancellation Fee Reduction in Force Cancellation Fee: $375.00 per incident
charge for failure to provide Company with 24 hour notice of
cancellation of Reduction in Force service.
FIRST AMENDMENT AND FIRST RENEWAL
OF CSC NO.47547-Exhibit A Page 5 of 8
Services Service Fees
Training and Education Bank of Training Hours: Eleven(11)hours of Training and
Education are included in the EAP Session Model PE/PM Rate.
Training and Education services may be on-site,or for web-
based seminars up to 50 participants. For webinars with more
than 50 participants,an additional charge of$25.00 applies for
each additional 25 participants up to a maximum of 200
participants. Additional Training and Education sessions are
$250.00 per hour for the total amount of time that the educator
is on site,plus a$150.00 per location charge for travel and
preparation time.If training is not scheduled consecutively or
multiple topics are scheduled,additional travel and preparation
costs may apply or additional hours may be deducted from the
bank. These capitated hours will be used for the total amount
of time that the educator is on site.
Sessions less than one(1)hour in duration will count as one(1)
hour of Training and Education.
If Customer requests a specific educator,or an educator with
specific qualities,including but not limited to specialized
certifications,experiences or language,Customer will be billed
any additional incurred fees beyond the hourly fee above or
have hours deducted from bank.
In addition,if Customer cannot accommodate the
schedule/availability of a local Company contracted educator,
requiring that the services of an educator 50 miles away or
greater from the Customer location is necessary,then Customer
will be billed any additional incurred fees beyond the hourly fee
above or have hours deducted from bank.
Training and Education Cancellation Fee Failure to provide Company six(6)business days' notice of
cancellation of a previously scheduled training program may
result in a charge of:
• Fee for Service Training Cancellation Fee: $375.00
per hour for services which are provided on a fee for
service basis and which are subject to the hourly rate.
• Bank of Training Hours Training Cancellation Fee:
Services which are included in the bank of capitated
hours described above,will result in the deduction of a
number of hours from the bank,equal to the number of
cancelled hours. When the bank of hours has been
exhausted,fee for service training cancellation fee of
$375.00 per hour applies.
FIRST AMENDMENT AND FIRST RENEWAL
OF CSC NO.47547-Exhibit A Page 6 of 8
Services Service Fees
Mental Health First Aid—8-Hour Course $9,200.00
This option provides eight(8)hours of standard Mental Health
First Aid curriculum.Fee includes all instructor fees,travel,and
customization
Volume Discounts:
Note:2 4-hour classes should ideally be scheduled same day;8-
hour classes consecutive days
5-10 classes— 10%Discount
11-20 classes— 15%Discount
21+classes—20%Discount
Mental Health First Aid-4-Hour Course $5,700.00
This option provides four(4)hours of standard Mental Health
First Aid curriculum. Fee includes all instructor fees,travel,and
customization
Volume Discounts:
Note: 2 4-hour classes should ideally be scheduled same day;8-
hour classes consecutive days
5-10 classes— 10%Discount
11-20 classes— 15%Discount
21+classes—20%Discount
Mental Health First Aid—Other Course
Options
2-Hour Onsite(All inclusive) $3,200.00
1-Hour Webinar $1,500.00
Mental Health First Aid Cancellation Fee If the Customer cancels for any reason within 30 days from the
Schedule training date,the Customer will be responsible for cancellation
fees
as follows:
• 50%of the total fee 15-30 days prior to the scheduled
date of training.
• 100%of the total fee 0-14 days prior to the scheduled
date of training.
FIRST AMENDMENT AND FIRST RENEWAL
OF CSC NO.47547-Exhibit A Page 7 of 8
Services Service Fees
Drug Free Workplace Services
$750.00 per case
Substance Abuse Case Management by
a Substance Abuse Professional(SAP)
and/or for Department of Transportation
regulation compliance
DOT Alcohol and Drug-Free Workplace for Supervisors
DOT training to meet Drug-Free Training to meet Drug-Free Workplace regulations regarding
Workplace regulations regarding drug drug and alcohol use. Additional fees may be added on to the
and alcohol awareness base rate for DOT training.These fees will be assessed on a
case-by-case basis and are dependent upon travel expenses and
for classes that exceed 50 participants.
•DOT Supervisor Training-2 hours at $800
DOT Alcohol and Drug-Free Workplace for Employees
Awareness Training(Note:this training does not meet Drug-
Free Workplace regulations regarding drug and alcohol use.)
Additional fees may be added on to the base rate for DOT
training.These fees will be assessed on a case-by-case basis and
are dependent upon travel expenses and for classes that exceed
50 participants.
• DOT Employee Training- 1 hour at$400
Company also may adjust Service Fees effective as of the date on which any of the following occurs.
1) If, for any Service, there is a (+/-) 20% change in the number of Employees from the number of Employees
assumed in Company's quotation as of the Effective Date of this Services Agreement.
2) Change in Services—A material change in Services is requested or initiated by the Customer or by legislative
action.
3) Premium Taxes or Assessments—If legislative or regulatory action results in the assessment of premium taxes
or other like charges as it concerns those Services provided under the terms of this Agreement.
FIRST AMENDMENT AND FIRST RENEWAL
OF CSC NO.47547-Exhibit A Page 8 of 8