Medical Associates MMPI-2 Testing Services Agreement Copyrighted
April 3, 2017
City of Dubuque Consent Items # 10.
ITEM TITLE: Medical Associates MMPI-2 Testing Services
SUMMARY: City Manager recommending approval of a one-year
agreement with the psychologists at Medical Associates
Clinic to provide MMPI-2 Testing Services administered to
all new Firefighters and Police Officers.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Approve
ATTACHMENTS:
Description Type
Medical Associates MMPI-2 Testing Services City Manager Memo
Agreement-MVM Memo
Medical Associates MMPI-2 Testing Services Staff Memo
Medical Associates MMPI-2 Testing Services Letter of Supporting Documentation
Agreement
THE CITY OF Dubuque
DUB E i"
Masterpiece on the Mississippi 2007.2012.2013
TO: The Honorable Mayor and City Council Members
FROM: Michael C. Van Milligen, City Manager
SUBJECT: Agreement between the City of Dubuque and Medical Associates Clinic,
P.C. to provide MMPI-2Testing Services
DATE: March 20, 2017
The MMPI-2 Psychological Test is administered to all new Firefighters and Police
Officers. The availability of the psychologist who has administered the MMPI-2 for the
last several years is limited.
Personnel Manager Randy Peck recommends City Council approval of a one-year
agreement with the psychologists at Medical Associates Clinic to provide this service for
a fee of $300 per employee.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
v
Mic ael C. Van Milligen
MCVM:jh
Attachment
cc: Crenna Brumwell, City Attorney
Cindy Steinhauser, Assistant City Manager
Teri Goodmann, Assistant City Manager
Randy Peck, Personnel Manager
THE CITY OF Dubuque
N-Amedca0ity
Masterpiece on the Mississippi 2007•2012•2013
TO: Michael C. Van Milligen, City Manager
FROM: Randy Peck, Personnel Manager
SUBJECT: Agreement between the City of Dubuque and Medical Associates Clinic,
P.C. to Provide MMPI-2 Testing Services
DATE: March 16, 2017
The MMPI-2 Psychological Test is administered to all new Firefighters and Police
Officers. The availability of the Psychologist who has administered the MMPI-2 for the
last several years is limited. Consequently, we need to identify another source to
provide this service. The psychologists at Medical Associates Clinic will provide this
service at a fee of$300 per employee. The initial term of the agreement is for one year
from the date it is approved. The agreement has been reviewed by City Attorney
Crenna Brumwell and she finds the terms acceptable.
I recommend that the City Council pass a motion approving the agreement between the
City of Dubuque and Medical Associates Clinic, P.C. for MMPI-2 testing services and
authorize you to sign the agreement.
RP:lmh
• Fjom:Medical Assoc Admin
563 584 4110 07/18/2017 16:17 #712 P.002/010
MEDICAL
•AssocIATEs
LETTER OF AGREEMENT— MMPI2 TESTING SF.RVICES
This Letter of Agreement. Is entered into -and made effective
Medical Associates Clinic, P,C, on behalf of Its Psychology De ar ' n „anti t
day o
SERVICES
MAC will provide pre-employment MMPI -2 testing, scoring, clinical I
for CITY for its Police andFire Departments,
MAC will send Police MMPI reports directly -toil
IntervieW and MMP adrnrnistratiOn, MACWill send Fire MMPI reptarts'ilire
Within.14 days of the clinical tote/I./low and MMPI administration.
2017 by and betWeen
e City of Dubuque loWa (Cif?),
rview and-cernprehe.nsive pSydholbg
tAlc$2,
CA -r7 .
-tiAti by within'14 Siotthe'clinfcai
'toCty of Dubuque Perscirinel !Via nager
rt
COMPENSATlON:.
CITY shall reimburse MAC $300 per employee for the indicated SerVices. CITY agrees to pay the inVdicad fee S with;
days of receipt, MAC may atilast pricing one time annually upon 30.clays.' notice to CITY In advance of the end of t
current term,
•TERM:
The initial term for this Agreement shall be fora period of drie.year from the effective datefiereof. This Agreement
automatically renew forsuccessive-one-year termsif not -acted upon .efther party In advance,ofthe anniversary date.
This Agreement may be terminated by either party, at any time, with -Or without cause, upon-thIrty C30) days written
notice to -the otherparty. Upon termination of thls Agreement, CITY shall remain' liable to MAC-forpayment oh any
services already provided by MAC;
Unless otherwise provided for in this Agreern(.!,.Pt,,all notices Willeh are required or may be given purstiantto the terms
of this Agreement'shall be In writing and shall be deemed duly given if delivered personally, mailed or sent.by facsimile
with confirmation, Notices shall be sent as follows;
To; MAC
Medial Associates Clinic, P,C,
Attention; CEa.
1500 Associates Drive
Dubuque, IA 52002
Telephone (533) 534-4100
Facsimile (563) 584-4110
With Carbon Coos To:
Medical Associates Clinic, PSycholOgyDepartrr,ent
Attention: Department Manager
200 Mercy Drive
Suite 201
Dubuque, IA 52.001
Telephone (5G3) 584-3500
Facsimile (56.3) 584-3520
FrOm:Medical Assoc Admin
By:
its; Ch
M
To: OM'
City of Dubilqua
Atentlon! Perkranei ril-nager
50 Wast-leStret
DubuquQ, IA 620P-1
Telephond (563) 5B9-411.5
Facsimile (563) 690-6025
563 584 4110 07/18/2017 16:19 #712 P.003/010
De
e Officer
elates ClItk, P.c.
By
(s C y, Mnager
City of Dubuque
City of Dubuque Insurance Requirements for:Professional Services
Insurance � �. Schedule �`
.��xx��w�v�^~
Medical Associates
I. Clinic,p'C, shall furnish osigned Certificate ofInsurance tothe City of Dubuque, Iowa for th
coverage required in Exhibit I prior to commencing work and at the end of the project if the term of work
s Ionger than 60 days Providers presenting annual certificates shall present a Certificate at the end of
each project with the final bU||ng. Each Certificate shall beprepared onthe most current ACDRDform
approved by the !owe Department of insurance or an equivalent. Each certificate shall Include a
5taternent under DescrptIon ofOperatons as to why Issued. Eg: Project ft or Project Locatlan at
or construction of
Z. AU pcIIces of Insurance required hereunder shall bowith acarrier authorized todobusiness )nIowa and
all carriers shall have a rating of A or better in the current A.M, Best's Rating Guide.
3. Each Certificate shall befur hhodtotheuontra:tingdopartmentofthcOtyofouhuque.
4. Failure to provide minimum coverage shall not be de.emed a waiver of these requirements by the City of
Dubuque, Failure to obtain or maintain the required Insurance shall be considered z material breach of
this agreement.
G. Consultants shal require all subconsultants and sub-subconsuitants to 'obtain and maintain during the
parfonnnrceofwork|nmmncafnrLhocovemQnydesudbed(nthb|mmrancoScbudu|eondsha8qbta\n
certificates of Insurances from ail such subconsultants and sub-subconsultants. Consultants agree that It
shall be liable for the failure of a subconsultants and sub-subconsultants to obtain and maintain such
- coverages. The City may requeSt a copy of such certificates from the Consultants.
G. Ail required endorsements to various poUcies shali be attached to Cerhficate of insurance,
7. Whenever aspecific ISO form Is Ilsted,ivdanthormmaybesubutitntudsubjec to the provlder
Identifying and listing in writing ell deviations and exclusions that differ from the ISO form.
8. Provider shall be required to carry the minirr,um coverage/limits, or greater If required by law or other
legal agreement, |nExhibit |. |fprovider's limits uliability are higher than the required minimum limits
9, Whenever an ISO form Is referenced the current edition of the form must be used.
P g Schedule C Professional REVISED For Spec Sltuation_2
City of Dubuque Insurance Requirements for Professional Services
��ec`�`����O^��rt
z�� -' Project
-'
insurance Schedule y`(CQnt^nued)
Exhibit
| A) COMMERCIAL GENERAL LIABILITY
General Aggregate Um|t $2,000000
Products -Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000/008
Each Occurrence $1,000,040
Fire Damage Limit (anyone oxcnrence) $ 50,000
Medical Payments• $ 5,000
8> WORKERS' COMPENSATION ,g4EKAPLOYERSLIABILITY ,-
Statutery benefits covering all eimployees Injured on the job by accident or disease as prescribed by
Iowa Code Chapter 85 as arnended.
Cove[ogmA Statutory—State ofIowa
Coverage Employers Liability ,
Each Accident $I00,000
Each Employee -Disease S100/000
Policy Limit -Disease $500,000
C) UM8R[LbAUAD|LITy $1,00000
Umbrella liability coverage must be at least following farm with the underlying policies included
herein,
0) PROFESSIONAL LIABILITY $1,000,000
a) Provlde evldenca of coverage for 5 years after completlon af project.
8) CYBER LIABILITY 1,000,000
Coverage for First and Third Party liability including but not limited to lost data and
restoraUon oss of tncome and cyber breach of nformation
Page 2 of 2
Yes X No
Schedule C Professional REVISED For Spec Situation_2