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1994-169-Execute An Amended Agreement With Medco Behavioral Care Of CaliforniaRESOLUTION 1994 - 169 RESOLUTION OF THE TOWN OF LOS GATOS AUTHORIZING THE TOWN MANAGER TO EXECUTE AN AMENDED AGREEMENT WITH MEDCO BEHAVIORAL CARE OF CALIFORNIA, INCORPORATED DBA PERSONAL PERFORMANCE CONSULTANTS OF CALIFORNIA FOR AN EMPLOYEE ASSISTANCE PROGRAM RESOLVED, by the Town Council of the Town of Los Gatos, County of Santa Clara, State of California, that the Town of Los Gatos enter into an amended agreement (attached) with Medco Behavioral Care of California, Incorporated dba Personal Performance Consultants of California for an employee assistance program, and that the Town Manager is authorized, and is hereby directed, to execute said amended agreement in the name and on behalf of the Town of Los Gatos. PASSED AND ADOPTED at a regular meeting of the Town Council of the Town of Los Gatos, California, held on the 5th day of December, 1994 by the following vote: COUNCIL MEMBERS: AYES: Randy Attaway, Joanne Benjamin, Steven Blanton, Linda Lubeck Mayor Patrick O'Laughlin NAYES: None ABSENT: None ABSTAIN: None SIGNED: AVA'� * MAYOR OF THE TOWN OF LOS GATOS LOS GATOS, CALIFORNIA 0 October 24, 1994 Mr. Mark Linder Director of Personnel Town of Los Gatos 110 E. Main Street Los Gatos, CA 95031 Dear Mr. Linder: This letter is to serve as a renewal of the current contract for the Employee Assistance Program (EAP) between MEDCO BEHAVIORAL CARE OF CALIFORNIA, INC., dba Personal Performance Consultants of California, Inc., and TOWN OF LOS GATOS, which is effective for the period of September 1, 1992 through August 31, 1994. The new contract term will be for one (1) year, extending from September 1, 1994 through August 31, 1995. Based on an employee Population of 185 the annualized professional fee will be $10,729.80, payable in quarterly installments of $2,682.45, due on the first day of each contract quarter. The following provisions have been added to your contract: Mandatory Referrals to HAP The Town of Los Gatos does not require any employee to participate in the EAP as a condition of continued employment. However, in the event that at any time the Town of Los Gatos requires that any Covered Employee participate in the EAP as a condition of continued employment, the Town of Los Gatos shall assume the risk of liability for and indemnify, defend, protect, and save harmless PPC, its officers, directors, employees, and Clinical Affiliates from and against any and all claims, damages, liabilities, losses, and expenses (including attorney's fees) for all injury, including death, to any person or persons whomsoever and damages to any property whatsoever arising out of any and all personnel actions of the Town of Los Gatos relating to such Covered Employees. In addition, prior to such a required participation, the Town shall notify PPC and reach a written agreement with PPC regarding the terms and conditions of the referral and participation. . Personal Performance Consultants, Inc 1401 S. Brentwood Blvd., Suite 400 St. Louis, MO 63144 Tel: 314- 963 - 1700/800- 333 -0226 Fax: 314 - 9639955 A MEDCO Behavioral Care Company Mr. Mark Linder October 24, 1994 Page Two Restriction of Providers In the event that at any time the Town of Los Gatos restricts PPC's choice of providers to which referrals for treatment may be made, whether through a provider panel maintained by the Town of Los Gatos or by its insurance carrier or managed care vendor other than PPC, the Town of Los Gatos shall assume the risk of liability for and indemnify, defend, protect, and save harmless PPC, its officers, directors, employees, and Clinical Affiliates losses, and expense (including attorney's fees) for all injury, including death, to any person or persons whomsoever and damaged to any property whatsoever arising out of referral to any such provider or providers unless such provider was at the time of the referral also a provider in PPG's provider network. Nothing in the foregoing shall relieve or exculpate PPC from liability for the negligent acts or omissions or wilful misconduct if PPC, its directors, officers, employees, or agents. All remaining terms of the Agreement remain unchanged and in effect. If this letter reflects your understanding of the new terms of our agreement, please have each letter signed by the appropriate person and return one to Leslie Rucker at 1401 S. Brentwood Boulevard, Suite 400, St. Louis, Missouri 63144. We appreciate your continued confidence in PPC® and are proud to be able to list Town of Los Gatos as one of PPC's clients. Sincerely, Dougl's Studebaker President MEDCO BEHAVIORAL CARE OF CALIFORNIA, INC. DATE: BY: DATE: APPROVED AS TO FORM: LARRY ANDERSON TOWN ATTORNEY TOWN OF LOS GATOS BY: ATTEST: MARIAN V. COSGROVE TOWN CLERK TOWN CLERK AGR• q@. 'a, z' -t- Z0. 1 EMPLOYEE ASSISTANCE PROGRAM AGREEMENTIHH: RENEWAL AGREEMENT REG: BID' This Agreement, entered into this CQ day of r� , 1988, by and between PERSONAL PERFORMANCE CONSULTANTS OF CALIFORNIA, INC., a Missouri corporation, 11111 Santa Monica Boulevard, Los Angeles, California 90025,(213)(479 -2254) (PPC J ), and TOWN OF LOS GATOS, Civic Center, 110 East Main Street, Los Gatos, California 95031 (Los Gatos). RECITALS 1. PPC is a private consulting firm that develops and maintains Employee Assistance Programs (EAPs) for business and industry. 2. PPC has applied for licensure as a specialized health care service plan under the Knox —Keene Health Care Service Plan Act of 1975. 3. Los Gatos is an employer desirous of contracting with PPC to provide an EAP for its employees and their families. THEREFORE, in consideration of the mutual covenants contained in this Agreement, and other good and valuable consideration, the parties agree as follows: 1. OBJECTIVES PPC will provide Los Gatos an EAP designed to meet the following program objectives: 1.1 To increase productivity, the bonds between the executive, organization. heighten morale, and strengthen the employee, and the 1.2 To provide Los Gatos employees and their family members undergoing personal difficulties with a resource to help them address personal problems. —1- 0683C ATTACHMENT � U I,5 PANE L__PROVIDER: A PPC Counselor or Clinical Affiliate. 2.6 COVERED EMPLOYEE: A regular full - -time or regular part -time employee of Los Gatos, 2.7 FAMILY MEMBER: A member of a Covered Employee's household and his /her ummarried dependent children, including step- children, adopted children, and foster children not residing with the Covered Employee. Children of a Covered Employee are not considered dependents if they are in the military service. 2.8 ENROLLEE: An individual eligible for participation in the EAP under this Agreement as a Covered Employee or a Family Member (as defined in this Agreement) of a Covered Employee, 2.9 FAMILY UNIT: A Covered Employee together with his /her Family Members, if any, 2.10 INPERSON SESSION: A fifty (50) minute counseling session for one or more Enrollees, individually or with members of his /her family, at a PPC office or the office of a PPC Clinical Affiliate. 2.11 EVIDENCE OF COVERAGE: The document issued to an Enrollee setting forth his /her eligibility for participation in the EAP. 2.12 SHORT -TERM COUNSELING; A brief, problem -- focused form of counseling that seeks resolution of problems in living (e.g „ parenting concerns, emotional stress, marital and family distress, alcohol and drug problems) rather than basic character change, emphasizes skills and counselee strengths and resources, and generally requires up to five sessions over a two to three month period. -3- 0683C 4.5 EMPLOYEE COMMUNICATIONS PPC will consult with Los Gatos on the employee communications program and provide selected promotional materials and activities. 4.6 PERSONAL CONSULTATION SERVICE PPC will provide professional, experienced counselors to make assessments of Enrollee problems and to provide short -term counseling, involving up to five inperson sessions per problem, as clinically appropriate. Access to service will be available through self - referral or supervisor- referral. The limits of confidentiality established with Los Gatos management in policy and procedure development will be fully explained to Enrollees prior to program participation. Counseling will be. provided by appointment on weekdays, evenings, and Saturdays. For emergency responsiveness, PPC will provide a round - the -clock answering service, with counselors on call 24 -hours a day, seven days a week, should the need for inperson intervention arise. Emergency requests for service will be accorded immediate attention. Access to counseling will. be available through supervisor referral and self -- referral. All. counselors serving as Panel Providers will have graduate level degrees in behavioral sciences and a minimum of three years clinical experience. Counseling will be available at any of PPC's offices and at the offices of PPC's Clinical Affiliates statewide. Enrollees will be able to make an appointment for counseling by calling (415) 969 -1919 (Mountainview- -San Jose area);or toll - -free (800) 888 -CARE (all other areas). All offices utilized will meet PPC's high standards of ease of entry /exit, location, parking, and general Enrollee comfort to assure maximum utilization and confidentiality of counseling services. -5-- 0683C 5. LIMITATIONS EXCEPTIONS AND EXCLUSIONS 5.1 CHOICE OF PROVIDERS. PPC will choose the Panel Provider who will deliver services to an Enrollee. However, PPC will take into account an Enrollee's choice of Panel Provider, whether due to dissatisfaction or other reasonable cause. In any event, PPC is obligated to make services available only through Panel Providers. 5.2 LIABILITY OF ENROLLEE FOR PAYMENT. If an Enrollee chooses to receive counseling, referral, or case management services from a Provider other than a Provider to whom PPC has referred the Enrollee for the particular problem, PPC will not pay for services rendered to the Enrollee, and the Enrollee may be liable to the Provider for the cost of services. 5.3 BROKEN APPOINTMENTS. An Enrollee will be deemed to have received one of the counseling sessions PPC is obligated to provide pursuant to this Agreement if any appointment made by such Enrollee with a Panel Provider was not kept, except in those cases where: (a) the Panel Provider is notifed at least 24 hours in advance of the appointment that it will not be kept; or (b) the appointment is missed because of an emergency or circumstances beyond the control of the Enrollee and the Enrollee is unable to give the Provider 24 hours advance notice of cancellation. 5.4 EXCLUSIONS. PPC has no obligation under this Agreement to provide any of the following services: 5.4.1 Inpatient counseling — This category includes any counseling or other services provided to an Enrollee while he /she is admitted as a patient in a general acute care or acute psychiatric hospital or other licensed health facility. —7- 0683C 5.4.10 Prescri tion Drugs — This category includes the dispensation of drugs or any other physical agents used to treat disease or functional disorder. 5.4.11 Involuntary Requirements to Underqo Counseling — This category includes, but is not limited to, all counseling required by an order of any California or Federal judicial officer or other governmental official mandating that an Enrollee undergo counseling for any reason whatsoever. 5.4.12 Evaluations or Professional Recommendations for Legal Proceedings — This category includes, but is not limited to, assessments to be used in child custody proceedings, child abuse proceedings, criminal proceedings, and legal actions of any kind against Los Gatos. 5.4.13 Drug Testing — This category includes the performance of any physical test conducted for the purpose of detecting the presence of alcohol or other mood — altering chemicals in an individual's body. 5.4.14 Fitness for Work Determinations — This category includes the performance of any professional assessment of an Enrollee for the purpose of determining for his /her employer whether he /she is mentally and /or emotionally capable /incapable of performing his /her job responsibilities at a given point in time in connection with an absence, leave, or return therefrom. 5.4.15 Treatment for Any Condition that is Compensable Under Workers' Compensation or Obtained Through or Required by Any Governmental Agency. 5.4.16 Legal Advice or Representation. 5.4.17 Financial or Investment Advice. 5.4.18 Exception to Exclusions — Notwithstanding that PPC has no obligation to provide the treatment or services identified in subparagraphs 5.4.2, 5.4.3, 5.4.15, 5.4.16, and 5.4.17, PPC will provide services for emotional /psychological problems caused by or related to the problems for which services will not be provided directly. 0683C (b) any Los Gatos payment is delinquent for more than thirty —one (31) days, Los Gatos has been duly notified and billed by PPC, and at least fifteen (15) days have elapsed since the date of notification. Provided, however, the receipt by PPC of the proper payment from Los Gatos after cancellation of this Agreement for delinquent payment shall reinstate the Agreement as though it had never terminated unless PPC shall within five (5) business days of receipt of such payment, either (1) refund the payment so made; or (2) issue to Los Gatos a new agreement accompanied by written notice stating clearly those respects in which the new agreement differs from the terminated agreement in services, coverage, or otherwise. 7.2.3 Cancellation by Sponsor or PPC — Either party may cancel this Agreement and be released from all obligations hereunder upon the occurrence of one or more of the following events: a) Insolvency, bankruptcy, dissolution, assignment for the benefit of creditors, or liquidation of the other party, or the appointment of a receivee over any of the property of the other party; b) Inability of the other party to properly perform obligations under this Agreement as a result of any law, decree, order, judicial or administrative decision of any jurisdiction. 7.2.4 Effective Date of Cancellation — Cancellation under subparagraphs 7.2.1 and 7.2.2 shall be effective fifteen (15) days after the date of written notice of cancellation. 7.3 EFFECT OF TERMINATION 7.3.1 PPC Materials — Upon the effective date of termination, Los Gatos right to use PPC Supervisor Resource & Training Manuals, employee communications materials, and other EAP materials furnished by PPC during the term of this Agreement shall terminate. —11- 0683C event that Los Gatos fails to pay any amount when due, the delinquent amount shall bear interest at the lesser of two percent per month or the maximum rate of interest allowable by law. 8.3 SERVICES AND COSTS COVERED PPC's professional fee covers all services and costs hereunder exclusive of postage and stationery associated with home mailings, and costs associated with employee communication materials developed exclusively for Los Gatos. 8.4 ENROLLEE FINANCIAL OBLIGATION No individual Enrollee shall be obligated in any way to pay for services rendered by PPC in accordance with the terms of this Agreement, including the payment of deductibles, copayments, or co- insurance. By statute, every contract between PPC and its Panel Providers provides that in the event that PPC fails to pay the Provider, the Enrollee shall not be liable to the Provider for any sums owed by PPC. In the event that the Panel Provider from whom an Enrollee receives counseling under this Agreement terminates his /her contractual relationship with PPC, PPC will arrange for another Panel Provider to deliver counseling services to such Enrollee without charge to Los Gatos or the Enrollee. 9. LOS GATOS OBLIGATIONS 9.1 DISTRIBUTION OF INFORMATION Los Gatos shall distribute to Covered Employees its information about the EAP and their eligibility for participation in the EAP, and copies of PPC's Evidence of Coverage and Disclosure Form. The Evidence of Coverage and Disclosure Form is a summary only; this Agreement should be consulted to determine the governing contractual provisions. —13- 0683C otherwise prov ded herein. PPC may terminate the eligibility of any Enrollee for fraud or deception in the use of the services provided by it or for knowingly permitting such fraud or deception by another, however, PPC will not terminate the eligibility of any Enrollee because of his /her health status or use of the EAP. 10.3 INDIVIDUAL CONTINUATION OF SERVICES An individual Enrollee does not have the right to renew his or her eligibility for services under this Agreement once his /her relationship (employment or otherwise) to Los Gatos is terminated. An Enrollee's right to receive such services is determined solely by this Agreement. 11. RELATIONSHIP OF PARTIES The relationship of PPC to Los Gatos shall be that of independent contractor. PPC assumes no responsibility for the supervision of any Los Gatos employee; such supervision and /or decisions regarding the employee are the responsibility of Los Gatos, 12, CONFIDENTIAL RELATIONSHIP Any information concerning Los Gatos, its products, services, personnel policies, or any other aspect of its business learned by PPC in the course of providing services pursuant to this Agreement shall be held in confidence and not be disclosed by PPC or any person or organization without the prior written consent of Los Gatos. Notwithstanding the confidential treatment of Los Gatos business information, PPC may identify Los Gatos as a PPC client. 13. RECRUITMENT OF PPC PERSONNEL Los Gatos agrees not to directly recruit any professional employed by PPC for any Los Gatos program that would replace any PPC EAP or conduct any business activity in competition with PPC during the term of this Agreement and for 18 months after termination of this Agreement. In the event of violation of this restriction, Los Gatos shall pay PPC as liquidated damages an amount equal to the annual salary of such person on the last day of his /her employment with PPC. -15- 0683C 16. MISCELLANEOUS 16,1 AMENDMENT This Agreement may be amended at any time by mutual agreement of the parties provided that before any amendment shall be operative, it shall be reduced to writing and signed by Los Gatos and PPC. Changes affecting the level of compensation to PPC shall not be effective until at least thirty (30) days following written notice thereof to Los Gatos except under the following conditions: the change is mandated by law; the change involves the addition of services or materials not included in this Agreement; or the change is otherwise provided for in paragraph 8 of this Agreement. 16.2 GOVERNING LAW This Agreement shall be governed by and construed according to the laws of the State of California. The EAP set forth in this Agreement is subject to Chapter 2.2 of Division 2 of the California Health and Safety Code and to Subchapter 5.5 of Chapter 3 of Title 10 of the California Administrative Code. Any provision required to be in this Agreement by either of the above shall bind PPC whether or not any such provision appears in this Agreement. 16.3 NOTICES All. written notices under this Agreement shall be sent to the parties at the following addresses: To Los Gatos: Debra figoni Assistant Town Manager Civic Center 110 Main Street Los Gatos, CA 95031 To PPC: Douglas E. Studebaker Personal Performance Consultants of California, Inc. 11111 Santa Monica Boulevard Suite 1845 Los Angeles, CA 90025 -17- 0683C ATTACHMENT A PERSONAL PERFORMANCE CONSULTANTS OF CALIFORNIA, INC. ENROLLEE GRIEVANCE PROCEDURE In the event any dispute arises under this Agreement, an Enrollee who is a party to such dispute may contact PPC at the address or phone numbers listed below. 1. PPC's Grievance Committee shall be comprised of two PPC Providers and the Chairperson. The Grievance Committee shall provide supervision over, and review grievances not resolved by, PPC's Clinical Director. The Chairperson of the Grievance Committee shall be appointed by PPC's Board of Directors and shall be an officer of PPC. The Chairperson shall have primary responsibility for the maintenance of the grievance procedures, for the review of their operations, and for the utilization of any emergent patterns of grievances in the formulation of policy changes and procedural improvements in PPC's administration. 2. An Enrollee may file a complaint about PPC's services or a Provider by appearing in person or writing PPC at: Personal Performance Consultants of California, Inc. 11111 Santa Monica Blvd., Suite 1845 Los Angeles, California 90015 (213) 479 -2254 or (800) 333 -3EAP (toll — free). Complaint forms and copies of the grievance procedure are available at PPC offices and the offices of PPC Clinical Affiliates. In addition, a copy of complaint form and /or the grievance procedure shall be sent promptly to the Enrollee on request. Completed forms should be submitted to the above address. Assistance will be provided by a PPC representative to anyone attempting to file a grievance in person or by telephone. —1- 0683C ADDENDUM TO EMPLOYEE ASSISTANCE PROGRAM AGREEMENT This ADDENDUM entered into this ____ day of , 1988, by and between Personal Performance Consultants of California, Inc., a Missouri corporation (PPC) and Town of Los Gatos (Los Gatos), is for the purpose of modifying the Employee Assistance Program Agreement of same date entered into by and between PPC and Los Gatos (the Agreement). 1. The parties have entered into this Addendum to provide Enrollees of Los Gatos with certain employee assistance program services in California during the interim period until PPC becomes licensed as a specialized health care service plan under the California Knox —Keene Health Care Service Plan Act of 1975. 2. Except as otherwise provided in this terms and provisions of the Agreement between shall remain in effect. The professional fee 5.1 of the Agreement with respect to services in California shall be suspended during the i becomes licensed and in lieu thereof. Addendum, all of the PPC and Los Gatos described in Paragraph to Covered Employees iterim period until PPC 3. In consideration of the services to be performed under the Agreement by PPC, Los Gatos shall pay PPC professional fees as follows: Administration Services Component $482.80 /per month Clinical Services Component $100.00 /clinical hour PPC shall bill Los Gatos on a monthly basis for administration services and clinical services provided during the preceding month. Upon licensure, the professional fee described in Paragraph 5.1 shall be reinstated, on a prorata basis, for the remainder of the contract term. - 1- 0683C Vto o� October 18, 1990 Martha Escobedo Administrative Technician Town of Los Gatos Civic Center 110 Main Street Los Gatos, CA 95031 Dear Martha: joWN CUMX IHH• R= 61D• SEE: ��•'' OYl Y This letter is to serve as a renewal of the current contract for an Employee Assistance Program (EAP) between the Town of Los Gatos and Personal Performance Consultants of California, Inc., which is effective for the period of September 1, 1988 through August 31, 1990. The new contract term shall be for two (2) years extending from September 1, 1990 through August 31, 1992. The professional fee will be $19,098.96 reflecting an annualized i professional fee of $9,549.48, payable n quarterly installments of $2,387.37 due on the first day of each contract quarter. Paragraph 16.3 NOTICES is changed to read: 16.3 NOTICES All written notices under this Agreement shall be sent to the parties at the following addresses: Martha Escobedo Administrative Technician Town.of Los Gatos Civic Center 100 Main Street Los Gatos, CA 95031 Douglas Studebaker President Personal Performance Consultants of California, Inc. 11111 Santa Monica Blvd Suite 1845 Los Angeles, CA 90025 All remaining terms of the original Agreement remain unchanged and in effect. ***a August 11, 1992 Ms. Karla Turner Personnel Analyst Town of Los Gatos 110 E. Main Street Los Gatos, CA 95031 Dear Ms. Turner: vwN CLERK ..,R 99,57 IHH: REda Bto: This letter is to serve as a renewal of the current contract for the Employee Assistance Program (EAP) between Personal Performance Consultants of California, Inc. and Town of Los Gatos, which is effective for the period of September 1, 1990 through August 31, 1992. -` The new contract term will be for two (2) years, extending from September 1, 1992 through August 31, 1994. Based on an employee population of 185, the annualized professional fee will be $10,122.45 for year one and $10,729.80 for year two, payable in quarterly installments of $2,530.61 for year one and $2,682.45 for year two payable on the first day of each contract quarter. Paragraph 16.3 NOTICES is changed to read: 16.3 NOTICES All written notices under this Agreement shall be sent to the parties at the following addresses: Mark Linder Director of Personnel Town of Los Gatos 110 E. Main Street Los Gatos, CA 95031 PERSONAL PERFORMANCE CONSULTANTS, INC. The Water Garden 1620 26th Street Suite 2050 Santa Monica, CA 90404 310 - 453-6727 Douglas Studebaker President Personal Performance Consultants of California, Inc. 1620 26th Street Suite 2050 Santa Monica, CA 90404