ADMINISTRATIVE REPORT

TO: Vancouver City Council

FROM: General Manager, Human Resources Services

SUBJECT: RFP No. PS03018 - Supply of Occupational Health and Disability Management Services Approval (Subject to Contract Execution) of Proposal from Medisys Health Group Inc.

RECOMMENDATION

CITY MANAGER'S COMMENTS

The City Manager recommends approval of the foregoing.

COUNCIL POLICY

The policy of Council is to award contracts for the purchase of equipment; supplies and services that will give the highest value based on quality, service and price. Contracts with a value over $300,000 are referred to Council.

BACKGROUND

In May 1995, Council authorized the General Manager of Human Resource Services to seek proposals from private sector firms to provide Occupational Health Services. The City conducted the request for proposal and evaluation process in accordance with City policy.
As a result Medisys Corporate Health Services Inc. was awarded the contract to provide occupational health services effective October 1, 1995 for a fifteen month period at a cost of $307,000 inclusive of all taxes including GST.
The City subsequently extended the contract several times over the years. The last extension of the contract with Medisys Corporate Health Services Inc. was for the period January 1, 2001 to July 31, 2003 at a cost not to exceed $300,000 per annum, inclusive of all taxes including GST.
The current contract provides occupational health services and disability management services, such as pre-placement medicals, periodic medicals for police officers, special medicals for hazmat officers, a Hepatitis B and influenza immunization program, medical monitoring for employees exposed to chemicals and metals, and a blood and body fluid exposure program in accordance with WCB regulation, consultative advice on medical issues, reviews of disability management certificates and consultative medical advice on claims management and return to work decisions.
In July 2002 the City started working with AON Consulting to review the existing contract and service levels. As a result of the review, and the size of the contract, and the marketing of all City benefit plans, it was determined that it would be prudent to go to market through the Request for Proposal process in order to ensure that the City is getting the best quality occupational health and disability management services for staff at a competitive price.
An evaluation team made up of staff from Police, Fire, Purchasing and Human Resource Services assessed the proposals against the following criteria:
· Understanding of the service requirements
· Proponent qualifications
· Quality and experience of the firm and the proposed services
· Price
The City received four bids from Ultima Medical Services, Organizational Health Inc., Columbia Health Centre and Medisys Health Group Inc. Of the four proposals, Ultima Medical Services and Organizational Health Inc. were deemed not able to meet the needs of the City as part of their proposals and were given no further consideration after the initial evaluation. The remaining two (2) short listed proponents were also interviewed. The purpose of the interviews was to determine the suitability of fit and to obtain more detailed information on the evaluation criteria.
Bid proponents were asked to submit proposals based on both our current service levels and possible increases to service levels that will be subject to 2004 budget discussions and approval.

Based on our current program usage the proposals were for the following amounts:

Proponent

Occupational Health Services

Disability Management Services

Total

Columbia Health Centre

$124,237

$160,800

$285,037

Medisys Health Group Inc.

$131,398

$173,250

$304,648

As mentioned, through the 2004 budget process the Human Resources Department will be seeking to expand existing occupational health services and disability management services to some staff not previously included. This would include expanding both the number of pre-employment medicals and periodic medicals and increasing preventative wellness initiatives at the City to help address rising benefits usage and costs. Proponents were asked to also quote on these higher service levels which may be phased in over several budget years to minimize the financial impact if these service level enhancements are approved.

Based on proposed program usage the proposals were for the following amounts:

Proponent

Occupational Health Services

Disability Management Services

Total

Columbia Health Centre

$264,237

$160,800

$425,037

Medisys Health Group Inc.

$320,773

$173,250

$494,023

DISCUSSION
Occupational Health Services

The prices shown above from the two proponents vary in price because Columbia Health Centre and Medisys Health Group use two distinct models for providing occupational health services.

The Columbia Health model utilizes the services of an occupational health nurse (OHN) as the first contact for all calls. The OHN refers matters to one of two consulting physicians. The model relies on the OHN to act as the primary contact/service manager and triage referrals, direct care, and deliver many of the services within the program. Columbia Health has been providing occupational health services, primarily at their centres outside of Vancouver with employers in a wide range of industries. At this time they have an occupational health nurse on retainer but do not have full time staff in place to provide occupational health services as specified in the proposal. The proposal specifies the same OHN would triage both occupational service and disability management calls. There is some concern on the service level and response time with this provider and the inability with the proposed staffing levels to meet the City's requirements.
 
Medisys Corporate Health has been providing occupational health services for the past eighteen years and has been the City's provider since 1995. The Medisys model provides a dedicated Occupational Health physician for the City of Vancouver who is familiar with City health programs, and who has worked extensively with first responders. A dedicated full-time physician will be assigned to the City and be able to respond to the majority of the occupational health calls, including calls after normal working hours. Although this is a higher level of service it is very important for our first responders that the response to their calls will be from an occupational health physician who is knowledgeable about occupational health programs at the City and the unique needs of the fire and police departments as they relate to occupational health matters.

Disability Management

The City of Vancouver has developed a Disability Management Program that primarily has provided a process to assist in an employee's return to productive employment post-illness or injury. In so doing, Return to Work Coordinators have worked closely with our employees, supervisors, and union representatives to provide employees with a successful return to work strategy following a disability, whether on a transitional or permanent basis. As a result of complex medical claims and awareness for medical confidentiality, the City does rely on an outside health care provider to assist in managing the disability management process.

The difference in pricing between the two proponents varies on a $15.00 per hour physician fee with Medisys Corporate Health Services being slightly higher on a physician only component. Both providers utilize a model of both occupational nurses and physicians. However, the Columbia Health model differs by limiting access to its physicians and potentially even the occupational health nurse by using the Director of Operations as a primary contact. This could delay early and supportive interventions with disabled workers, as soon as appropriate, following the reporting of a disability. Delays do result in a continued absence from the workplace, and therefore impacting potentially on an employee's income stream if they could have returned sooner. Furthermore, Columbia Health did present themselves as being somewhat hesitant of proactively working with the City to manage disability (e.g. quarterly meetings, report capabilities, up-front gap analysis of policies and procedures, education of staff, etc.) without additional fees for those services, if they could even be provided. Therefore, it was felt that again there would be some concern over service levels, response times, and an overall willingness to work with the City on alternative disability management models.

Medisys Corporate Health Services and the City have a strong connection with its Occupational Health Physician, who would not directly be involved, but would assist the dedicated occupational health physicians and nurses exclusively assigned to the City of Vancouver. Staying with the existing service provider would also reduce the amount of disruption if case files were to be transferred to a new provider. The day-to-day contact with one (or more) occupational health nurse(s) provided by Medisys would assist in timely interventions as required. Furthermore, if service levels were not being met the City could request changes to staffing levels or the "fit" of the occupational health nurses. Medisys health nurses utilize a sophisticated disability tracking software, which also has extensive reporting capabilities and would assist the City in assessing its disability management needs (e.g. claim frequencies, nature of absences, etc). Security of medical information is of the utmost importance and Medisys processes fall within the Vancouver Police Departmental (VPD) requirements for its employees.

Medisys currently provides Disability Management Services for many large and medium sized employers across Canada. The occupational health nurses have access to occupational specialists through the occupational clinics, such as psychiatrists, which upon request can quickly provide their medical expertise reducing time away from work and improving successful return to work initiatives. Medisys is also more willing to proactively work with the City to manage disability by looking at the City's needs and providing custom fit solutions within its contract.

FINANCIAL IMPLICATIONS

The total estimated cost of this contract is $304,648 per annum. The existing budget of $284,500 for medical fees and $25,400 for related services for a total of $309,900 is held within the Human Resource Services departmental budget. Therefore, there are no budgetary implications in accepting either proponent based on our current programs.

CONCLUSION

The evaluation team is of the opinion that there is value for the City to have one provider for both occupational health services and disability management services for continuity of service and familiarity of the service provider with the City's staff and programs.

In the view of the evaluation team, the proposal of Medisys Health Group Inc. provides the best value to the City and the company has the qualifications, resources and experience to deliver the occupational health and disability management services. Medisys Health also has a higher level of understanding of the City's requirements and has made itself available to custom fit their solutions to the City's needs.

Therefore, it is recommended that the contract for the provision of occupational health and disability management services be awarded to Medisys Health Group Inc.

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© 2002 City of Vancouver