Employee Assist Prog ServicesMEMORANDUM
September 3, 2003
TO:
FROM:
SUBJECT:
The Honorable Mayor and City Council Members
Michael C. Van Milligen, City Manager
Agreement with Mercy Medical Center to provide Employee Assistance
Program Services
Personnel Manager Randy Peck is recommending approval of an agreement with
Mercy Medical Center to provide employee assistance services to the City of Dubuque
employees and their family members.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
Micl~ael C. Van Milligen
MCVM/jh
Attachment
cc: BarTy Lindahl, Corporation Counsel
Cindy Steinhauser. Assistant City Manager
Randy Peck, Pesonnel Manager
CITY OF DUBUQUE, IOWA
MEMORANDUM
September 3, 2003
TO:
FROM:
SUBJECT:
Michael C. Van Milligen
City Manager
Randy Peck ~,~
Personnel Manager
Agreement with Mercy Medical Center to provide Employee Assistance
Program Services
I have attached an agreement with Mercy Medical Center to provide employee
assistance services to City of Dubuque employees and their family members. The annual fee
will be $5,300 dollars effective July 1,2003, and it represents an increase of $530 dollars over
the previous year fee schedule. The City of Dubuque has had an Employee Assistance
Program since 1989; This is the third increase in their fee since 1991. The last increase
occurred in Fiscal Year 2002. The annual fee can be financed within the approved Fiscal
Year 2004 budget. The annual fee will be in effect through June 30, 2005. The Agreement
has been reviewed by our Corporation Counsel Barry Lindahl and he has found it acceptable.
I recommend that the Agreement be approved. I request that the City Council approve a
motion authorizing you to sign the Agreement.
If you have any questions, please feel free to call.
RP:bf
Enclosure
AGREEMENT
EMPLOYEE ASSISTANCE PROGRAM
The Mercy Medical Center Employee Assistance Program (EAP) agrees to provide the
following services to the City of Dubuque:
1. Employee Services. These services shall include:
A. Assessment, evaluative counseling, referral, case management and follow-up
for all employees and their family members.
There is no set limit of the number of sessions allowed for each client, but will
be determined by the counselor and parties involved based on a need basis.
All sessions involving the client and EAP are at no charge to the employee.
Any charge from another provider other than EAP will be the responsibility of
the employee or his or her insurance.
In the case of employees who are referred by the employer, when a threat of
disciplinary action accompanies referral, follow-up services will be provided.
Follow-up will be for a period of time determined by the parties involved and
will consist of the following:
· monthly meetings between the employee and the EAP counselor,
· weekly contact with any agency the employee is referred to for the
duration of his/her involvement at that agency,
monthly contact with the supervisor who made the referral. This
contact will not involve disclosure of information as to the nature of
the employee's problem or recommended treatment. It will serve to
inform the supervisor as to the level of the employee's involvement
and progress being made in dealing with the identified problem(s).
2. Utilization Review Services.
Mercy Medical Center EAP shall provide, on at least an annual basis,
statistical data relevant to the utilization of the EAP by employees and their
family members. This data shall reflect the number of employees and their
family members who have used the program voluntarily and formally, as well
as a breakdown of the types of problems dealt with. This data will be
statistical in nature and will not include the names of any employees or their
family members using the program.
3. Fees.
Mercy Medical Center EAP shall be paid at the rate of $10.00 per year times the
number of full and part-time employees of the City of Dubuque as indicated in the
following calculation. Full-time employee is herein defined as any employee
working thirty-two (32) hours or more per week.
530
Number of Full and Part-time Employees
x $10.00 Per Employee
=$5,300.00
Annual Fee
4. Manner of Payment.
The fee shall be paid to the Mercy Medical Center EAP on an annual basis.
5. Revision/Termination/Effective Date.
The terms of this agreement go into effect on July 1,2003. This agreement may
be modified by either party by mutual consent on thirty (30) day written notice of
intent to revise the agreement. Either party wishing to terminate this agreement
must give thirty (30) days written notice to other party.
6. Insurance.
During the term of this agreement, Mercy Medical Center EAP shall maintain
insurance as set forth in the attached Insurance Schedule.
7. Indemnification.
Mercy Medical Center agrees to defend, indemnify and hold the City harmless
from and against any and all claims arising out of Mercy's negligent performance
of this agreement.
Signed this day of ,2003.
Russell M. Knight
President and Chief Executive Officer
Memy Medical Center
Michael C. Van Milligen
City Manager
City of Dubuque
Revised 9/2003
3. Fees.
Mercy Medical Center EAP shall be paid at the rate of $10.00 per year times the
number of full and part-time employees of the City of Dubuque as indicated in the
following calculation. Full-time employee is herein defined as any employee
working thirty-two (32) hours or more per week.
530 Number of Full and Part-time Employees
x $10.00 Per Employee
=$5,300.00 Annual Fee
4. Manner of Payment.
The fee shall be paid to the Mercy Medical Center EAP on an annual basis.
5. Revision/Termination/Effective Date.
The terms of this agreement go into effect on July 1, 2003. This agreement may
be modified by either party by mutual consent on thirty (30) day written notice of
intent to revise the agreement. Either party wishing to terminate this agreement
must give thirty (30) days written notice to other party.
6. Insurance.
During the term of this agreement, Mercy Medical Center EAP shall maintain
insurance as set forth in the attached Insurance Schedule
7. Indemnification.
Mercy Medical Center agrees to defend, indemnify and hold the City harmless
from and against any and all claims arising out of Mercy's negligent performance
of this agreement.
Signed this /6 day of J ? ��'-��. S = , 2003.
/ �'4'f-(-6 ,t4 //t/U .�
Russell M. Knight
President and Chief Executive Officer
Mercy Medical Center
Revised 9/2003
Michael C. Van Milligen
City Manager
City of Dubuque
SCHEDULE C
INSURANCE REQUIREMENTS FOR PROFESSIONAL SERVICES
All policies of insurance required hereunder shall be with an insurer authorized to
do business in Iowa. All insurers shall have a rating of A of better in the current
A.M. Best Rating Guide.
All policies of insurance shall be endorsed to provide a thirty (30) day advance
notice of cancellation to the City of Dubuque if cancellation is pdor to the
expiration date. This endorsement supersedes the standard cancellation
statement on the Certificate of Insurance.
shall furnish a Certificate of Insurance to the City of
Dubuque, Iowa for the coverage required in Paragraph 6 below. Such
Certificates shall include copies of the following endorsements:
a) Thirty day notice of cancellation to the City of Dubuque.
b) Commemial General Liability policy is primary and non-contributing.
c) Commercial General Liability additional insured endorsement.
d) Governmental Immunities Endorsement.
e) Waiver of Recovery under workers compensation.
shall also be required to provide Certificates of
I'nsurance of all subcontractors and all sub-sub contractors who perform work or
.services pursuant to the previsions of this contract. Said certificates shall meet
the same insurance requirements as required of
4. Each certificate shall be submitted to the contracting department of the City of
Dubuque.
Failure to provide minimum coverage shall not be deemed a waiver of these
requirements by the City of Dubuque. Failure to obtain or maintain the required
insurance shall be considered a material breach of this agreement.
6. Contractor shall be required to carry the following minimum coverage/limits or
greater if required by law or other legal agreement:
a) COMMERCIAL GENERAL LIABILITY
General Aggregate Limit $2,000,000
Products-Completed Operations Aggregate Limit $1,000,000
Personal and Advertising Injury Limit $1,000,000
Each Occurrence Limit $1,000,000
Fire Damage Limit (any one occurrence) $ 50,000
Medical Payments $ 5,000
This coverage shall be written on an occurrence, not claims made, form
per project. All deviations or exclusions from the standard ISO
commercial general liability form CG 0001 or Businessowners BP 0002
shall be cleady identified.
Page l 0£4
August 2003
SCHEDULE C
INSURANCE REQUIREMENTS FOR PROFESSIONAL SERVICES
Governmental Immunity endorsement identical or equivalent to form
attached.
An additional insured endorsement identical or equivalent to ISO Form
CG 2026 and include as'additional insureds: "The City of Dubuque,
including all its elected and appointed officials, all its employees and
volunteers, all its boards, commissions and/or authorities and their board
members, employees, and volunteers."
b) WORKERS COMPENSATION & EMPLOYERS LIABILITY
Statutory for Coverage A
Employers Liability:
$100,000 each accident
$100,000 each employee-disease
$500,000 policy limit---disease
Policy shall include an endorsement waiving right of recovery
against City of Dubuque.
c) PROFESSIONAL LIABILITY: $1,000,000
d) UMBRELLA/EXCESS LIABILITY
Coverage to be determined on a case-by-case basis by Finance Director.
Page 2 of 4
August 2003
POLICY NUMBER COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE pART.
SCHEDULE
Name of Pcrson Or Organization:
The City of Dubuque, including all its elected and appointed officials, all its employees and volunteers, all
its boards, commissions and/or authorities and their board members, employees, and volunteers.
(If no entry appears above, information required to complete this endorsement will be shown in the
Declarations as applicable to this endorsement.)
WHO IS AN INSURED (Section H) is amended to include as an insured the person or organization shown
in the Schedule as an insured but only with respect to liability arising out of your operations or premises
owned by or rented to you.
Covwfuht. Insurance Services Office. Inc. 1994
CG 20 26 11 85
Page 3 of 4
August 20~3
CITY OF DUBUQUE, IOWA
GOVERNMENTAL IMMUNITIES ENDORSEMENT
Nonwaiver of Governmental Immunity. The insurance carrier expressly
agrees and states that the purchase of this policy and the including of the City
of Dubuque, Iowa as an Additional Insured does not waive any of the
defenses of governmental immunity available to the City of Dubuque, Iowa
Under Code of Iowa Section 670.4 as it is now exists and as it may be
amended from time to time.
Claims Coverage. The insurance carrier further agrees that this policy of
insurance shall cover only those claims not subject to the defense of
governmental immunity under the Code of Iowa Section 670.4 as it now exists
and as it may be amended from time to time. Those claims not subject to
Code of Iowa Section 670.4 shall be covered by the terms and conditions of
this insurance policy.
Assertion of Government Immunity. The City of Dubuque, Iowa shall be
responsible for asserting any defense of governmental immunity, and may do
so at any time and shall do so upon the timely written request of the
insurance carrier.
Non-Denial of Coverage. The insurance carrier shall not deny coverage under
this policy and the insurance carrier shall not deny any of the rights and
benefits accruing to the City of Dubuque, Iowa under this policy for reasons of
governmental immunity unless and until a court of competent jurisdiction has
ruled in favor of the defense(s) of governmental immunity asserted by the City
of Dubuque, Iowa.
No Other Change in Policy. The above preservation of governmental immunities
shall not otherwise change or alter the coverage available under the policy.
Page 4 of 4
August 2003