ADMINISTRATIVE REPORT
Date: June 27, 1995
TO: Vancouver City Council
FROM: Manager of Occupational Safety and Rehabilitation in
consultation with the General Manager of Community Services
SUBJECT: Occupational Health Services - Restructure
RECOMMENDATION
A. THAT Council approve the outsourcing of occupational health
services to an external provider, resulting in the reduction
of three (3) FTE and one (1) Temporary positions detailed in
this report;
B. THAT Council approve Medisys Corporate Health Services Ltd. as
the provider for the current occupational health services
required by the City at a cost of $276,000; and
C. THAT Council authorize an additional $29,000 to the contract
to increase the level of service for pre-placement testing for
Fire and Police recruits and the Hazmat Team annual physicals.
GENERAL MANAGER'S COMMENTS
The General Manager of Human Resource Services RECOMMENDS approval
of A-C.
COUNCIL POLICY
In May, 1995, Council authorized the General Manager of Human Resource
Services to seek proposals from private sector firms to provide
Occupational Health Services effective October 1, 1995.
PURPOSE
The purpose of this report is to seek Council's approval to outsource
occupational health services, to enter into a contract with Medisys
Corporate Health Services Ltd.(Medisys) for those services, to upgrade
the service within the existing budget, and to allow for transitional
funding within the existing budget.
BACKGROUND
The Occupational Health Services Division currently operates under the
Health Department and is housed in the City Hall east wing annex. It
provides services in four basic categories: pre-placement screening,
annual medicals, medical return-to-work decisions, and general medical
services. In May, 1995, Council approved the General Manager Of Human
Resource Services to seek alternative delivery methods for occupational
health services for 1995 and to re-negotiate the City Occupational
Health Plan with its unions and employee groups in 1996.
DISCUSSION
Occupational Health Services provides services to varying City
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departments including pre-placement medicals, annual medicals,
vaccinations, first aid for City Hall, medical monitoring of chemical
exposures, screening of employees returning to work after an illness or
injury, and various other minor medical services. A review of those
services has occurred which identified areas for improvement:
1. Service is only provided during regular working hours. Both Police
and Fire have indicated that this does not meet their needs as this
time is often at their peak activity and cannot spare crews for
testing;
2. The type of pre-placement and annual medicals conducted needs
updating to more contemporary standards. Operating departments have
indicated that they require more physiological testing to assess
the individuals' fitness to work. This can not been done with
current resources;
3. The new rehabilitation program has put the responsibility of
returning employees to work in the hands of the supervisor and our
rehabilitation case coordinators. Any medical information required
is now received from the family doctor or the rehabilitation
clinic. Experience to-date indicates that supervisors can place
individuals safely without additional staff;
4. Having a physician as a City employee has created perceptions of
bias.
Through a request for proposal process, six invitations were sent to
known providers and two additional providers were identified through ads
placed in the Sun and Province newspapers. Two full and complete
proposals were returned. The remaining six indicated either that they
were not set up to deliver a large program or could not provide an
occupational health physician. The types of services requested in the
proposal process were:
- pre-placement physicals (fire, police and labour positions)
- annual physicals (fire and police positions)
- special medicals (Hazmat team)
- Hepatitis "B" program (shots and exposure counselling)
- Return to work decisions
- Medical consultation
- Medical emergency protocol reviews
- Medical monitoring program
The purpose of issuing the request for proposal was to see if services
could be delivered effectively at lower cost. Modern occupational
health emphasizes matching individuals to the job by conducting pre-
placement and annual physicals that measure their capability to do the
job. Due to the high cost of equipment procurement and the need to
provide service to departments in a timely fashion, the only way the
City can accomplish this within the existing budget is to outsource the
occupational health services. Both proposals received indicated that
this can be accomplished within the existing occupational health budget
allocation.
Submissions were screened by an inter-departmental group of City staff.
This group evaluated the written proposals on the ability of the firm to
manage the work, the firm's capacity to do the work, and the cost to do
the work. They also interviewed the individual selected by the firm to
be the designated occupational health physician (director). The purpose
of this interview was to determine this individual s suitability to fit
with the current City culture.
The team recommended Medisys Corporate Health Services as the provider.
This recommendation was based upon a number of key factors:
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1. Service can be mobile and provided seven days a week or as
necessary without additional cost to meet the needs of the
operating departments;
2. The individual who would function as the occupational health
physician (director) has extensive occupational health experience
in both public and private organizations; and
3. Medisys has extensive experience in all aspects of occupational
health and has experience with other municipal operations (City of
Montreal, City of Toronto Parks, Property and Engineering, Delta
Police, Surrey Firefighters, North Vancouver Firefighters,
Vancouver Engineering Department.)
4. Medisyshad thelowestbid at$276,000with theotherproposal at$279,000.
PERSONNEL IMPLICATIONS
There are 2.5 full-time equivalent positions in addition to the
occupational health physician that support the activities of
Occupational Health Services. These are:
1. Occupational Nurse (job share between two individuals)
2. Administrative support (one full-time regular and one part-time
temporary).
The full-time administrative support position is now vacant due to staff
changes. Medisys has indicated that affected staff will be interviewed
first for positions that they have available. All affected staff will
access their rights under the appropriate collective agreement (BCNU or
VMREU). Staff have been informed of the decision to outsource all
activities of occupational health and active work is occurring to assist
staff.
The Fit City coordinator will be unaffected by this change in service
delivery other than being part of Human Resource Services instead of the
Health Department.
FINANCIAL IMPLICATIONS
There is approximately $355,500 spent on occupational health services
City-wide. Staff believe occupational health services can be provided
in a format that will cost less and yet improve the level of service
and activities to user departments. This can only be accomplished by
outsourcing the services.
CURRENT OCCUPATIONAL
HEALTH EXPENDITURES $ 355,500
BASIC SERVICE COST $ 276,000
UPGRADE COSTS (Fire/Police
pre-placement, Hazmat tests) 29,000
SUB-TOTAL $ 305,000 $ 305,000
SAVINGS $ 50,500
The review process in 1996 of the Occupational Health Plan will look at
the type of annual physical testing for City employees. A further
report in 1996 will be presented to Council on the results of that
review and there may be a request for additional funds to support an
improved level of service.
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A copy of this report has been provided to all civic unions/
associations.
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