City of Phoenix Firefighter Health Services IGA

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INTERGOVERNMENTAL AGREEMENT
BETWEEN
THE CITY OF PHOENIX
AND
THE CITY OF CHANDLER
FOR FIREFIGHTER HEALTH SERVICES AT THE PHOENIX FIRE DEPARTMENT
HEALTH CENTER

164379--0
AGREEMENT NO.
(City of Phoenix)

This Intergovernmental Agreement (“IGA”) is entered into this 27thday of _sune

2025 (“Effective Date”), by and between the City of Phoenix, for and on behalf of the
Phoenix Fire Department (“the City”), and the City of Chandler, for and on behalf of the

Chandler Fire Department (“the Customer”). Throughout this Agreement, the City and the

Customer individually may be referred to as “Party” and may be referred to collectively as

“Parties” to this Agreement.

RECITALS

WHEREAS, the City Manager of Phoenix, is authorized and empowered by provisions of
the City Charter to execute contracts; and,

WHEREAS, the City is authorized and empowered to enter into intergovernmental
agreements for the provision of services or for joint or cooperative action pursuant to
Arizona Revised Statutes (A.R.S.) §11-952. The City is also authorized and empowered
pursuant to Chapter 2, Section 2 (i), of the Charter of the City of Phoenix; and,

WHEREAS, agreements for mutual assistance and intergovernmental cooperation in
public safety areas, including operations and management of fire and police, or the public
safety related agencies have existed between municipalities and governmental
jurisdictions; and,

WHEREAS, it is the desire of the municipalities, governmental jurisdictions, agencies and
fire districts participating in this Agreement, to work together for mutual benefit of the
public, Customer's community and all of the Customer’s personnel; and,

WHEREAS, the Customer desires to participate in the firefighter health services offered
at the Phoenix Fire Department Health Center (the “Health Center’); and,

WHEREAS, the City has entered into an Agreement with a Medical/Occupational and
Wellness Health Services vendor to furnish services and operate the Health Center
including, but not limited to, annual firefighter physical examinations; and,

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WHEREAS, the City desires the participation of the Customer to more effectively provide
annual firefighter medical examinations for sworn personnel as required by (i) federal and
state law and/or national fire service standards; and (ii) regulations as deemed necessary
by the Fire Chiefs of their respective fire departments; and,

WHEREAS, Ordinance No. S-51789 dated April 9, 2025 authorized the
City to enter into an agreement with Chandler Fire Department for the Health Center to
provide services to Chandler Fire Department firefighters and police officers.

AGREEMENT

NOW THEREFORE, in consideration of the mutual promises, inducements, covenants,
agreements, conditions and other good and valuable consideration, the receipt and
sufficiency which is acknowledged, the Parties agree as follows:

ARTICLE t. PURPOSE

1. The purpose of this Agreement is to define the delivery of health services that will be
provided by the Health Center to the Customer. These services include physical
examinations, immunizations, return to work evaluations, and exposure management.

2. The Customer will reimburse the City for all services performed. In addition, the
provision of services to other jurisdictions will not negatively impact the City's public
safety personnel.

ARTICLE Il. STATEMENT OF SERVICES

1. The Customer's personnel may participate in the selected health services and
programs, as listed in Exhibit A — IGA Services Menu, provided by the Health Center
and any other such employee health and safety programs the Health Center may have
to offer. If any other such employee health and safety programs that the Health Center
may offer are to be utilized by Customer personnel, all such health and safety
programs will only be made available and provided after written contract amendment
to this Agreement. Services are to be provided at the Health Center or such other
location designated by the City.

ARTICLE ill. TERM OF THE AGREEMENT
1. Term:
This Agreement shali commence on the Effective Date referenced above and shall
continue in force for five (5) years, or until terminated by formal act of the Parties.
2. Termination:

Either party may terminate this Agreement at any time by providing thirty days (30)
written notice to the other Party. Either Party at their convenience, by written notice,

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may terminate this Agreement. If this Agreement is terminated, the Customer will be
liable under the provisions of this contract for services and material rendered and
accepted. In addition, the Parties acknowledge that this Agreement is subject to the
cancellation by either party pursuant to the provisions of A.R.S. § 38-511.

ARTICLE IV. GENERAL TERMS AND CONDITIONS

1. Governing Law; Forum; Venue:

This Agreement is executed and delivered in the State of Arizona, and the substantive
laws of the State of Arizona (without reference to choice of law principles) will govern
their interpretation and enforcement. Any action brought to interpret or enforce any
provision of this Agreement that cannot be administratively resolved, or otherwise
related to or arising from this Agreement, will be commenced and maintained in the
state or federal courts of the State of Arizona, Maricopa County, and each of the
Parties, to the extent permitted by law, consents to jurisdiction and venue in such
courts for such purposes.

2. Implied Contract Terms:
Each and every provision of law and any clause required by law to be in this Contract
shall be read and enforced as though it were included herein, and, if through mistake
or otherwise, any such provision is not inserted, or is not correctly inserted, then upon
the application of either Party, the Contract shall be physically amended to make such
insertion or correction.

3. Entire Agreement; No Waiver; Amendment:

This Agreement is intended by the undersigned Parties as the final expression of their
agreement and is intended to be the complete and exclusive statement of the terms
of the agreement between the Parties. No course of prior dealings between the
Parties and no usage in the trade shall be relevant to supplement or explain any term
used in this Agreement. Acceptance or acquiescence in a course of performance
rendered under this Agreement shall not be relevant to determine the meaning of this
Agreement even though the accepting or acquiescing Party has knowledge of the
nature of the performance and the opportunity to object. Any delay or failure to
exercise or enforce any right, power, privilege, or remedy under this Agreement by a
Party may not be deemed a waiver, release, or modification of the requirements of
this Agreement or any of its terms or provisions by that Party. This Agreement may
not be modified or amended except in a writing signed by both Parties.

4. Confidentiality and Data Security:

4.1 All data, regardless of form, including originals, images and reproductions,
prepared by, obtained by, or transmitted to the Customer in connection with this
Agreement is confidential, proprietary information owned by the City. Except as
specifically provided in this Agreement, the Customer will not disclose data
generated in the performance of the Services to any third person without the prior
written consent of the City Manager, or his/her designee.

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4.2 Personal identifying information, financial account information, or restricted City
information, whether electronic format or hard copy, must be secured and
protected at all times to avoid unauthorized access. At a minimum, Customer
must encrypt and/or password protect electronic files. This includes data saved
to laptop computers, computerized devices or removable storage devices. When
persona! identifying information, financial account information, or restricted City
information, regardless of its format, is no longer necessary, the information must
be redacted or destroyed through appropriate and secure methods that ensure
the information cannot be viewed, accessed, or reconstructed.

4.3 In the event that data collected or obtained by the Customer in connection with
this Agreement is believed to have been compromised, Customer will notify the
City Privacy Officer immediately. Customer agrees to reimburse the City for any
costs incurred by the City to investigate potential breaches of this data and,
where applicable, the cost of notifying individuals who may be impacted by the
breach.

4.4 Customer agrees that the requirements of this Section will be incorporated into
all subcontractor/sub consultant agreements entered into by the Customer. It is
further agreed that a violation of this Section will be deemed to cause irreparable
harm that justifies injunctive relief in court. A violation of this Section may result
in immediate termination of this Agreement without notice.

4.5 The obligations of Customer under this Section will survive the termination of this
Agreement.

5. Health Insurance Portability and Accountability Act (HIPPA) of 1996:
The Parties certify that each is familiar with the requirements of HIPAA, as amended
by the Health Information Technology for Economic and Clinical Health Act (HITECH
Act) of 2009, and accompanying regulations and will comply with all applicable HIPAA
requirements in the course of this Agreement. The Parties warrant that each will
cooperate in the course of performance of the Agreement so that the Parties will be in
compliance with HIPAA.

6. Third-Party Beneficiary Clause:
The Parties expressly agree that this Agreement is neither intended by any of its
provisions to create any right of the public or any member thereof as a third party
beneficiary, nor to authorize anyone not a Party to this Agreement to maintain a suit
for personal injuries or property damage pursuant to the terms or provisions of this
Agreement.

7. Fund Appropriation Contingency:
The Parties understand that the continuation of this Agreement is subject to the budget
of the Parties providing for the contract item as an expenditure. The Parties cannot

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assure that the budget item for funding this Agreement will be approved in the future.
In such event, either Party may terminate this Agreement.

8. No Joint Venture:
No term or provision in this Agreement is intended to create a partnership, joint venture
or agency arrangement between any of the Parties.

9. Assignment and Delegation:
Neither this Agreement, nor any of its rights or obligations, may be transferred or
assigned by either party without the prior written consent of both Parties. Any attempt
to assign this Agreement without prior written consent will be void and may result in
penalties up to and including termination of the Agreement.

10. Independent Contractor Status:
The Parties agree that neither party shall be deemed io be an employee or agent of
the other Party to this Agreement and that the relationship created by this Agreement
is that of independent contractors. Neither Customer nor any of Customer's agents,
employees or helpers will be deemed to be the employee, agent, or servant of the
City. Customer, its employees and subcontractors are not entitled to worker's
compensation benefits from the City.

11.Workers’ Compensation:

The Parties agree that it is the responsibility of each Party to ensure that its employees
are notified in accordance with the provision of Arizona Workers’ Compensation Law,
specifically, A.R.S. § 23-1022, or any amendment thereto, and that all such notices,
as required by such laws, shall be posted accordingly. That by signing this Agreement
and to ensure compliance with the notice posting requirements, each Party grants
consent to all other Parties to inspect that Party’s respective premises and work places
upon request of any of the other Parties. However, nothing in this Agreement should
be construed as imposing a duty to inspect another Party's respective premises and
work places, and this agreement does not create a joint or employer/employee
relationship between a Party and another Party's employees.

12. Severability:
The provisions of this Contract are severable to the extent that any provision or
application held to be invalid shall not affect any other provision or application of the
Contract which shall remain in effect without the invalid provision or application.

13.Compliance with Laws:
The Customer will comply with all existing and subsequently enacted federal, state
and local laws, ordinances, codes, and regulations that are, or become applicable to
this Agreement. If a subsequently enacted law imposes substantial additional costs,
a request for an amendment may be submitted pursuant to this Agreement.

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14.Drug Free Workplace:
The Parties will comply with the Drug Free Workplace Act of 1988 and will permit
inspection of its personnel records to verify such compliance. A Party’s breach of the
above-mentioned warranty shall be deemed a material breach of the Agreement and
may result in the termination of the Agreement.

15. Immigration Requirements:

The Parties will comply with the Immigration Reform and Control Act of 1986 (“IRCA’)
and will permit inspection of its personnel records to verify such compliance. To the
extent applicable under A.R.S. § 41-4401, each Party warrants compliance with all
federal immigration laws and regulations that relate to its employees and compliance
with the E-verify requirements under A.R.S. § 23-214(A). Each Party has the right to
inspect the papers of the other Parties participating in this Agreement to ensure
compliance with this paragraph. A Party's breach of the above-mentioned warranty
shalibe deemed a material breach of the Agreement and may result in the termination
of the Agreement.

16, Legal Worker Requirements:
The City is prohibited by Arizona Revised Statutes § 41-4401 from awarding an
agreement to any organization who fails, or whose subcontractors fail, to comply with
Arizona Revised Statutes § 23-214(A). Therefore, the Customer agrees that:

16.4 Each subcontractor the Customer uses warrants their compliance with all federal
immigration laws and regulations that relate to their employees and their
compliance with Arizona Revised Statutes § 23-214,

16.2 A breach of warranty will be deemed a material breach of the Agreement and is
subject to penalties up to and including termination of the Agreement.

16.3 Only through an audit with the Customer, will the City retain the legal right to
inspect the papers of the Customer or subcontractor employee(s) who work(s)
on this Agreement to ensure that the Customer or subcontractor is complying
with the warranty.

17.Dis position of Property:
Upon cancellation or termination of this Agreement, each party will retain ownership
of their solely provided property for the purposes of disposing of property on
termination.
ARTICLE V. PAYMENTS

1. Contracted Rates:
The current rates for health services and programs are as set forth in Exhibit A- IGA
Services Menu.

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2. Invoicing:
The City will issue invoices, on a thirty (30) day cycle, to the Customer for the selected
services and for any other programs and/or services offered to and received by the
Customer's personnel pursuant to this Agreement. Infection control services will be
billed annually on the last day of the month of December.

3. Payments:
The Customer shall make payment to the City for all amounts invoiced at the
applicable rates. It is further agreed that a violation of this Paragraph will cause
irreparable harm, justifying injunctive relief in a court of law. A violation of this
Paragraph may result in immediate termination of this Agreement without notice. The
obligations of the Customer under this Paragraph shall survive the termination of this
Agreement.

ARTICLE VI. INSURANCE AND INDEMNIFICATION

1. Insurance:

The physicians contracted by the City to deliver the services provided by this
Agreement shall have medical malpractice and professional liability insurance at limits
of no fess than one million dollars ($1,000,000). All insurance coverage and self-
insured retention or deductible portions, except workers’ compensation insurance and
professional liability insurance, if applicable, shall, for claims arising out of the
performance of the Agreement, name, to the fullest extent permitted by law, the
Parties and their agents, represeniatives, officers, directors, officials and employees
as additional insureds.

2. Indemnification:
Each party (as “Indemnitor”) agrees to indemnify, defend, and hold harmless the other
party (as “Indemnitee”) from and against any and all claims, losses, liability, costs, or
expenses (including reasonable attorney’s fees) (“Claims”), but only to the extent that
such Claims which result in vicarious/derivative liability to the Indemnitee are caused
by the act, omission, negligence, misconduct, or other fault of the Indemnitor, its
officers, officials, agents, employees, or volunteers.

Each party must use its best efforts to cause all contractors (each an “Additional
Indemnitor’) to indemnify, defend, save and hold harmless the other party from and
against any and all Claims caused, or alleged to be caused, in whole or in part, by the
negligent or willful acts or omissions of the Additional Indemnitor [and persons for
whom they are vicariously liable].

Indemnifications Survive. The provisions of this Agreement wherein a Party has
explicitly indemnified the other Party shall survive the expiration or earlier termination
of this Agreement.

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ARTICLE VII. NOTICES

1. Any notice, consent, or other communication (“notice”) required or permitted under
this Agreement must be in writing and either delivered in person, sent by facsimile
transmission, deposited in the United States mail, postage prepaid, registered or
certified mail, return receipt requested, or deposited with any commercial air courier
orexpress service addressed as follows:

If to City: If to Contractor:

Phoenix Fire Department Chandler Fire Department
150 S. 12" Street 151 E. Boston Street
Phoenix, AZ 85034 Chandler, AZ 85225

Attn: Michael J. Duran Attn: Tom Dwiggins
Phoenix Fire Chief Chandler Fire Chief
Telephone: (602) 256-3189 Telephone: (480) 782-2120
Fax: (602) 262-4429 Fax: (480) 782-2150

Notice will be deemed received at the time it is personally served or, on the day it is
sent by facsimile transmission or, upon deposit with any commercial air courier or
express service or, if mailed, ten (10) days after the notice is deposited in the United
States mail as provided above. Either Party may change its mailing address, fax
number, or the contact information for the person to receive notice by notifying the
other Party as provided herein. Notice sent by facsimile transmission must also be
sent by regular mail to the recipient at the above address. This requirement for
duplicate notice is not intended to change the effective date of the notice sent by
facsimile transmission.

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IN WITNESS WHEREOF, this Agreement is executed as provided below. Further, in
signing this Agreement, the signatories below affirm and attest that they are authorized
to execute this Agreement on behalf of their respective Party.

CITY OF PHOENIX, a municipal corporation
Jeffrey Barton, City Manager

Michael J. Duran
Fire Chief

ATTEST:
etre flossald

City Clerk Noy 24, 2025

APPROVED AS TO FORM:
Dard Lavelle

David Lavelle .

Assistant Chief Counsel &CS
CITY OF CHANDLER, a municipal corporation
Joshua Wright, City Manager

By: Kus Pate
Kevin Hartke
Mayor

ATTEST:

Dana k. Lveng.
City Clerk, Chandler

APPROVED AS TO FORM:

City Attorney, Chandler
DUG

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In accordance with A.R.S. §11-952 (D), this Agreement has been reviewed by the
undersigned who determined that it is in appropriate form and is within the powers and
authority of the respective parties.

CITY OF PHOENIX
Dawid Lavelle
By:

David Lavelle “Re

Assistant Chief Counsel

Date: AUet>, 202s , 2025
CITY OF CHANDLER
City Attorney, Chandler
DIAG
Date: _June 27 , 2025

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EXHIBIT A

IGA Services Menu

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Phoenix Fire Department IGA Services Menu
Health & Wellness Center (Exhibit A)
150 S. 12" Street

Phoenix, AZ 85034

Requesting Agency Name:

(i.e., City of Phoenix Fire Department) Chandler Fire Department

All services listed are available based on Health and Wellness Center scheduling capacity
limitations. Our services are offered to outlying agency active fire personnel (sworn and non-sworn)
and specialty unit law enforcement personnel that require the use of a Self-Contained Breathing
Apparatus (SCBA) as part of their essential job duties.

The Physical Exam is offered as the baseline service for the IGA. Additional services are offered in
our services menu at additional costs. The contracting agency requesting the IGA must identify
their intentions regarding the additional services by selecting to “Opt In” or “Opt Out” of each
service from the menu options below.

Service Each

PHYSICAL EXAM: $718.00

e Patient Health Review Survey

¢ Blood testing and analysis consisting of: Chem 18/HDL/Lipid Panel/CBC/Uric

Acid, UA/Micro

Prostate Specific Antigen (PSA) blood test - (Males only, age 40 and older)
Hepatitis-B Antibodies — FF Recruits/New Patients only

Hepatitis-C Antibodies — FF Recruits/New Patients only

Varicella Titer — FF Recruits only

Hearing Conservation Program - Hearing Test and Evaluation (assessed in an
ANSI-approved soundproof audiometric booth)

Visual Acuity Testing & Evaluation

Vital Signs - temperature, pulse, respiratory rate, and blood pressure
Spirometry/Pulmonary Function Test & Evaluation

EKG Stress Test (treadmill)

o FF Recruits/New Patients complete a MAX Treadmill test; a Sub-max
treadmill test is performed annually thereafter unless otherwise determined
by a Health & Weliness Center Clinician. Non-sworn fire personnel complete
a resting EKG only.

« Chest X-Ray
o FF Recruits/New Patients for baseline and every 4 years thereafter, unless

Health & Wellness Center Clinician determines otherwise.

e Skin fold measurement by calipers, body weight, & height

e Immunization history screening and review

e¢ Consult with physician or physician assistant to discuss physical examination
o Level-A Doctors Written Statement of Respiratory Usage Form Completion
o Tier Medical Assessment Form Completion

rpoa-Hnx<IrV
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ADDITIONAL SERVICES:
Please select to “Opt In” or “Opt Out” for each service menu option below.

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TIER PROGRAM MW OPT IN | [] OPT OUT
The Tier 4 Health Assessment is a program that places members in a category or TIER TIER
tier based on their annual physical assessment. Historically, we have recommended Program Program

¥ removing people from active duty if we saw something during their physical that was

I unhealthy, dangerous, or physically limiting. These not-fit-for-duty members were

E prescribed rehabilitation methods with the goal of returning them back to active duty

R as soon as possible. This program is rehabilitative, not punitive.

“Opting in” to our Tier Program requires that the participating agency cover the costs

P of Tier follow ups, lab testing, and treadmill testing for their members. Peer Fitness

R Trainer Support or resources should be made available through the participating

oO agency to assist their employees in wellness improvement. The PFD Health &

G Wellness Center's role is to identify the employee’s Tier status. Management of

R employee's progress regarding follow-ups and testing, shall be the employer's

A responsibility. (Tier Program Defined document provided upon request)

M | TIER Follow-Up $75.00 $0.00
TIER Follow-Up with Treadmill $200.00 $0.00
TIER Lab Draw (Repeat A1c Lab retesting) $37.00 $0.00
IMMUNIZATIONS J OPT IN | 4 OPT OUT
“Opting in” to the immunization program assures that we will provide Immunizations Immunizations
vaccinations to your department members. Immunizations will only be
administered if it is deemed necessary by Health & Wellness Center

I Medical Team. Your department will only be billed for the immunizations

M given to your members. Every effort will be made to provide the most

M effective immunization series that is medically necessary to protect the

U member.

f Tdap (Tetanus/Diphtheria/Pertussis) 1 shot $68.25 x 1 $0.00

Zz

A Tetanus/Diphtheria 1 shot $50.70 x 1 $0.00

T

; $80.60 x 2

‘ MMR (Measles/Mumps/Rubella) 2 shot series (S161 20/series) $0.00

N aig § = $121.55 x 2

S Hepatitis-A (Havrix) 2 shot series (S243.10/series) $0.00
Hepatitis-B (Engerix) 3 shot series $56.55 x 3 $0.00
(+ blood draw to check antibodies after completed series) ($169.65/series) ‘
Twinrix (Hep A and B Combo) 3 shot series $14755x3 $0.00
(+ blood draw to check Hep-B antibodies after completed series) ($442.65/series) .
IB TESTING

T By “opting in” for the T-Spot TB blood testing you agree that your L] OPT IN | MY OPT OUT

B department will pay for the Phoenix Fire Department Health & Wellness T-Spot TB T-Spot TB

t Center to perform T-Spot TB blood testing for all your new hire firefighter Testing Testing

E recruits/new patients to establish a baseline and then on any of your

Ss members should a TB exposure occur while on duty.

T

y__ | T-Spot TB Blood Test ssn $6.00

G (FF Recruits/New Patients for baseline and then following TB exposure only) ‘ .

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Return to Work Evaluations | OPT IN | (.] OPT OUT
Occasionally, your department may request that an employee be evaluated Return to Return to
at the PFD Health & Wellness Center regarding a return-to-work evaluation. Work Evals Work Evals
These evaluations take place after a release to full duty by employee’s
treating surgeon or physician for an injury or illness.
Costs associated with a return-to-work evaluation may vary depending on
what is needed. Below are the base costs. Choosing to “opt in” for this
service will allow your members to be seen at the Health & Wellness Center
R for these types of visits. Your department will only be billed for the services
T provided at the time of the visit.
Ww Return to Work Evaluation Assessment
(Clinician’s review of all notes and work release information related to Return-to- $100.00 $0.00
E Work injury or illness)
V $100.00
A (minimum)
L Return to Work Physical Exam by Clinician $0.00
(Clinician’s physical exam of patient related to Return-to-Work injury or illness) $105.00 / hr. .
s (after first hour
with Clinician)
X-Ray per view if required
(cost varies based on the location and complexity of the injury) $70:50:200:00 $0.00
Resting EKG $67.00 $0.00
Bloodwork Testing if required Per Test $0.00
Flat Rate
R Medical Records Requests
E
c
fe) Individual requests for medical records for personal reasons will be Individual $0.00
R completed at no charge with the receipt of a signed medical records release
D authorization. Please allow 5-7 business days for completion of request.
Ss
For requests of 25 medical records or less we will provide 1 year of physical 25 or less $0.00
R exam information (most recent) to include: clinician's notes, all test results,
E and complete immunization record at no charge. Requests will be filled
Q upon receipt of signed medical records release authorization. Please allow
U 14 business days for completion of requests.
E
Ss For requests of more than 25 medical records we will provide 1-3 years of 25 or more $1,000.00
T physical exam information, to include: clinician's notes, all test results, and
Ss immunization records and a flat rate will be charged. Requests will be filled
upon receipt of signed medical records release authorizations. Please allow
30-45 business days for completion of requests.

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rFOWAZON 20-AOmMT1Z—

=SPAOOADV

Infection Control Program and ICO Assistance [_] OPT IN | J OPT OUT
Infection Infection
Please note: Geographically, we are limited on the distance that this service Control Control
can be provided. Therefore, this option is only available to agencies within Program Program
the Phoenix Metropolitan area.
For agencies within the Phoenix Metropolitan area, choosing to “opt in” for
the Infection Control Program, we will provide your members with Infection
Control Officer assistance based on the following objectives and
responsibilities. Pricing details for this service are listed below.
Major Objectives:
¢ To ensure quality of care of patients and department members.
«To provide a liaison between medical facilities, the medical examiner and
the state's public health office.
« To assist your department ensuring compliance with federal, state and
local laws and regulations.
« To develop and institute a comprehensive program for exposure
notification and medical follow-up.
« To monitor compliance with department's infection control
practices/procedures.
* To update exposure control program to include T.B. control.
PFD Infection Control Officer Responsibilities:
« Work with administration, risk management and safety on infection control
and related compliance issues.
« Establish and maintain records on employee exposures, medical follow-up
and personnel health.
« Will ensure reporting and documentation of exposures, medical follow-up,
confidentiality and record keeping.
« Work with medical facility representatives to ensure timely exposure
notification, testing and reporting.
e Will interview and assist exposed department personnel.
« Assist in evaluation of new products and equipment relating to infection
control - OSHA compliance.
« Assist with the development of new infection control policies and
procedures for your department.
e Work with medical examiner regarding exposures involving deceased
persons.
Annual Per Member Fee (active members only) $66.00 $0.00

If participating in the Infection Control program, the fees listed below apply and will only be billed to your
department if an exposure occurs and testing or treatment is required. Please note: This contract does not
include or cover prophylaxis. Prophylaxis charges received by Phoenix Fire will be recovered via invoice to the

participating agency.

Exposure Consult with Health & Wellness Center Clinician $75.00 $0.00
Hepatitis C Antibody (lab draw) $44.00 $0.00
Hepatitis C Confirmatory (lab draw) $100.00 $0.00
HIV Antibody (lab draw) $25.00 $0.00
Hepatitis A Vaccine (Havrix) 2 shot series oan oe x2 $0.00
Tetanus/Diphtheria Vaccine 1 shot $50.70 $0.00
Tdap Vaccine (Tetanus/Diphtheria/Pertussis) 7 shot $68.25 $0.00
Activation of Post Exposure Prophylaxis (PEP) Line $250.00 $0.00

(pricing may vary depending on service provided by PEP Clinician)

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Docusign Envelope ID: 14F3711D-C4CC-40F6-88D6-A365B4EA2238

Physical Exam Scheduling:

We will provide all participating agencies with the appropriate number of designated appointment dates and
time slots for your member's physical exams (firefighter recruits, new patients, and annual physicals). Once
the dates and times have been provided, it will be up to your department's liaison to provide our scheduler
with the individual names of the members that will be occupying the time slots. For firefighter recruits and
new patients, the Patient Health Review packet will need to be completed as a “new” patient and received at
the PFD Health & Wellness Center at least 5 business days prior to the appointment date to create an
Electronic Health Record, medical chart, and prepare the appropriate paperwork that will be needed at the
time of the visit. Not providing the requested packet in the requested time frame, may result in the release of
the scheduled physical exam appointment.

Firefighter Recruit Physical Exam Scheduling:

Our annual physical schedule is completed 60-90 days in advance. Every effort will be made to
accommodate firefighter recruit physical requests when ample notice is given to the Health & Wellness
Center. Short notice requests for firefighter recruit physical spots will be considered, but accommodations
are not guaranteed.

All other appointment types (i.e., Exposure Consults & Return to Work Evaluations) will be scheduled on an
individual basis.

Bloodwork/Lab Draws:

FF Recruits/New Patients:

All bloodwork required for firefighter recruits or new patient physical exams shall be drawn at the PFD Health
and Wellness Center located at 150 S. 12" St., Phoenix, AZ. This is a fasting lab draw. No food eight (8)
hours prior to lab draw, only black coffee and water are permissible during the eight (8) hour fasting period.
The fasting lab draw should be completed 3-5 business days prior to the scheduled physical exam. The
Patient Health Review Packet information must be provided to the Health & Wellness Center prior to lab
work being drawn. An Electronic Health Record must be established in advance to link the lab work to the
patient record.

Annual Physical Bloodwork/Lab Draws:

Once the initial (pre-hire or new patient) lab draw is completed at the Health & Wellness Center, contracting
agencies may continue to utilize the Health & Wellness Center for all annual physical lab work, or they may
have lab work done at a lab location through the contracted lab vendor with the Phoenix Fire Department
Health & Wellness Center. No internal blood draws within your department will be permitted, unless
facilitated with Phoenix Fire Health & Wellness Center staff. All participating agencies shall work with the
PFD Health & Wellness Center staff to coordinate the bloodwork required for your department, confirm
contracted lab vendor and locations, and ensure the correct lab slips are provided to the lab at the time of
the blood draws. The Phoenix Fire Department's contract agreement with our laboratory services vendor
does not include “on site” phlebotomy services for wellness fairs or events held at individual fire
departments. Services rendered for “on site” phlebotomy will need to be arranged with the lab separately
and all “on site” phlebotomy service charges will be the responsibility of the fire department requesting these
services.

Cancellations, No Shows, and Unused Reserved Appointments:

Life is busy, and we understand that unforeseen circumstances can take place preventing members from
making their scheduled appointments. We would appreciate a minimum 24-hour notice for cancellations.
We will work with your department's liaison, or with the individual, to reschedule an appointment due to
unavoidable circumstances. However, a no show with no call to notify our department, or reserved
appointment slots that are unused, may result in a charge to your department. We want to be respectful of
your time and would ask for the same courtesy in return.

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