HomeMy WebLinkAboutHoward Sofen, MD - 2021-04-01 PROFESSONAL SERVICE'S CONTRACT 13FTWEEN
THE CITY OF I IUNTINGTON BEACH AND
Hoord Sofen, Mp
FOR
INDEPENDL'NT MEllICAL EVALUATIONS WITH
RFSPI CT 1'O WORKERS' COMPENSATION CLAIMS
THIS AGREF.MP,N'1'("Agl•eenicnt") is made and entered into by and between the City of
Huntington Beach, a municipal corporation of the State of California, hereinafter rofcrred to as
-um- and ffowwt 6 S o�� all individual, hereinafter referred to as "PHYSICIAN."
WFIF.REAS, CITY desires to engage the services of a physician to provide independent
medical evaluations with respect to workers' compensation claims; and
Pursuant to documentation an file in the office of the City Clerk, (he provisions of the
Hi mtington Beach Municipal Code, Chapter 3.03, relating to procurement ol'professional service
contracts have been complied with; and
PHYSICIAN has been selected to perform said services,
NOW, THEREFORE, it is agreed by CITY and PHYSICIAN as follows:
1, SCOPE OF SERVICES
PHYSICIAN shall provide all services as described in Exhibit "A," which is
attached hereto and incorporated into this Agrcemcnt by this reference. These services shall
sometimes hereinafter be referred to as the "PROJECT.,,
PHYSICIAN hereby designates 1-} wCL-y a- S 0 F� who shall represent it
and Ix; its sole contact and agent in all consultations will) CITY during the performance of this
Agreement.
A APPROVED AS TO FORM/�'x
A
IICHAEL E. GATES
CITY ATTORNEY
rm.roc w inirFnIr_rnni ncnru
2, CITY STAFF ASSISTANCE
CITY shall assign a staff coordinator to work directly with PHYSICIAN in the
performance of this Agreement.
3. TIME-, OI' PERFORMANCE.
Time is of the csscnce of this Agreement. Tile services of PHYSICIAN are to
cumnlence on ln f 11.l,.2 (%'L olte "Coululenecmenl Dale"). This Agreement shall
automatically renew three(3) years Irunl the Commencement Dale, unless terminated as provided
hcrcin. The Bute for performance of the tasks identified in Exhibit"A" are generally to be. shown
in Csshihit "A." This schedule ntay be Amended to benefit the PROJECT if mutually agreed to in
writing by CITY and PHYSICIAN.
In lltc event the Com mealreulcmt I:)ate precedes the Effective Dale, PHYSICIAN
shall be bound by all terms and couditions as Provided herein.
4. COMPENSATION
In consideration of the. Pcrlin•nlauce of the services described herein, CITY agrees
to pay PHYSICIAN, oil it at little, Alld materials IJa5i5 at the rates specified in Exhibit "13," Attached
hereto and incorporated by reference into this Agreement, it fee, including all costs and expenses,
not to exceed Twcnty-nine Thousand Nine-I lunched Dollars ($29,900.00).
5. RXTRA WOKK
In the event CITY requires Addiliomll services not included iu l,xhibit "A", or
changes in the scope of service's described in Exhibit "A," PHYSICIAN will undertake such work
only alter receiving written aulhorization front CITY. Additional compensation for Well extra
work shall be allolvcd only if the prior written approval of CITY is obtained.
6. METHOD OF PAYMENT
PHYSICIAN shall be paid pursuant to the terms of Exhibit "W"
7. DISPOSITION OF PLANS ESTIMATES AND OTF11 R DOCUMENTS
PHYSICIAN agrees flint title to all materials prepared hereunder, including, but not
limiled to: all original drawings, designs, reports, both Field and office notices, calculations,
computer code, language, data or programs, maps, memoranda, lepers and other documents, shall
belong to CITY, and PHYSICIAN shall turn these materials over to CITY upon termination of
this Agreement or upon PROJECT completion, whichever shall occur first. Tliese materials may
be used by CITY as it sees fit.
8. 1IOLD HARMLESS
PHYSICIAN hereby agrees to protect,defend, indemnify and hold harmless CITY,
its officers, elected or ap}xwiatecl officials, employees, agents and volunteers from and against any
and all claims,damages, losses, expensesJudgmenls, demands and defense costs(including without
limitation, costs and fees of litigation of every nature or liability of any kind or nature) arising out
of or in connection with PHYSICIAN's (or PHYSICIAN's subcmriraclurs, if any) negligent (or
alleged negligent) performance of this Agreement or its failure to comply with any of its obligations
contained in this Agreement by PHYSICIAN, its officers, agents or employees except such loss or
damage which was caused by the sole negligence or willful misconduct of CITY. PHYSICIAN will
conduct all defense at its sole cost and expense and CITY shall approve selection of PHYSICIAN's
counsel. This indemnity shall apply to all claims and liability regardless of whether any insurance
policies are applicable. The policy limits do not act as limitation upon the amount of indemnification
to be, provided by PHYSICIAN,
9. PROFESSIONAL LIABILITYINSURANCE
PHYSICIAN shall obtain trod furnish to CITY a professional Viability insurance
policy covering the work performed by it hereunder. This policy slinll provide coverage for
PHYSICIAN's professional liability in an amount not less than One Million Dollars
($1,000,000,00) per occurrence and in the aggregate. The above-mentioned insurance shall not
coilt8al a sett-lllsul'Cd retell Iioll wltllont (bc express writtelt collsCllleft.',ITY; however nn insurance
policy "deductible' of Ten Thousand Dollars ($10,000,00) or Icss is permitted. A claims-macle
policy shall be acceptnbic if the policy further provides that:
A. The policy retroactive date coincides with or precedes (lie initiation of the
scope of work (including subsequent policies purchased as renewals or
replacements).
B. PHYSICIAN shall notify CITY of circumstances or incidents that might
Live rise to future claims.
PHYSICIAN will make every effort to maintain similar insurance during the
required extended period of coveragc folluwing PROJECT completion, If insurance is terminated
for any reason, PHYSICIAN agrees to pnrchasc an extended reporting provision of at least two (2)
years to report claims arising from work performed in connection with this Agreement.
If PHYSICIAN fails or refuses to produce or maintain the insurance required by
this section or fails or refuses to furnish the CITY with required proof that insurance has been
procured and is in force and paid for, the CITY shall have the right, at the CITY's election, to
forthwith terminate this Agreement. Such termination shall Itot affect PHYSICIAN's right to be
paid for its lime and materials expended prior to notification of tcmr'nlination. PHYSICIAN waives
file right to receive compensation and agrees to indemnify the CITY f'or any work performed prior
to approval of insurance by the CITY.
10. CERTIFICATES OF INSURANCE,
Prior to commencing performance of the work licreunder, PHYSICIAN shall
furnish to CITY certificates of insuranw subject to approval of the City Attorney cvideneing the
foregoing insurance coverage as required by this Agreement the celif cats shall:
A, provide the name and policy number of each carrier and pol icy;
B. slate that the policy is currently in force; and
C. promise that such policy shall not be suspended, voided or canceled by
either party, reduced in coverage or in limits except after thirty (30) days,
prior written notice; however, tell (10) clays' prior written notice in the event
of cancellation for uonpaynicnt of premium.
PHYSICIAN shall maintain the foregoing insurance coverage in force until the
work undef this Agreement is fiilly completed and accepted by CITY.
The requirement for carrying (lie foregoing insurance coverage shall not derogate
from PHYSICIAN'S defense, hold harmless and indemnification obligations as set forth in this
Agreement. CITY or its representative shall al all limes have the right to demand (lie original or e
copy of the policy of insurance. PHYSICIAN shall pay, in a prompt and timely matuner, the
premiums on the insurance hereinabove required.
11. INDEPENDENT CONTRACTOR
PHYSICIAN is, and sliall be, acting al all times in the perlurmauce of this
Agreement as an independent contractor herein and not as an employee of CITY. PHYSICIAN
shall secure at its own cost and expense, and be responsible for any and all payment of till taxes,
social security, state disability 111S111'ancc conlpellsftUoll, unelnpioynleut coulpensatiun and other
payroll deductions for PHYSICIAN atld its officers, ngenls and employees and all business
licenses, if any, in connection with the PROJECT and/or the services to be performed hereunder.
12. TL?RMINATION 01' AGREEMENT
All work. required hereunder shall be performed it, a good and workmanlike
manner. CITY uuty terminate PHYSICIAN'S services hereunder at any tinge with or without cause,
and \yliether or not the PROJECT is filly complete. Ally termination of this Agt'ecincnt by CITY
shall be made in writing, notice of which shall be delivered to PHYSICIAN as provided herein,
In the event of termination, all finished and unfinished documents, exhibits, report, and evidence
shall, at the option of the CITY, become its property and shall be promptly delivered to it by
1)1YSICIAN.
13. ASSIGNMENT AND.D1?LEGATION.
This Agreement is a personal service contract and the work hereunder shall riot be
assigned, delegated or subcontracted by PHYSICIAN to any other person or entity without the
prior express written consent of CITY. If till assignment, dcicgldion or subcontract is approved,
all approved assignees, delegates and subcontractors must satisfy the insurance, requirements as
set furlh in Sections 9 and 10 hereimbove.
14. COPYRIGHTS/PATENT'S
CITY shall own all rights to any patent or copyright on any work, item or material
produced as a result of this Agreement.
15. CITY EMPLOYEES AND OFFICIALS
PHYSICIAN shall employ no CITY official nor any regular CITY employee in the
work pui Cormod pursuant to thin Agreement. mo omeer or ampinyee of CITY shall have any
financial interest in this Agreement ill violation of the applicable provisions of (hc California
Government Code.
16. NOTICES
Any notices, certificates, or other communications hereunder shall he given either
by personal delivery to PI IYSICIAN's agent (as designated in Section I hercinabove) or to CITY
as the Silllatiell slltlll W81-1.811t, or by olelosing the sank in a scaled envelope, postage prepaid, and
depositing the same ill the United States Postal Service, to the addresses specified below. CITY
and PHYSICIAN may designate different addresses to which subScquon notices, certificates or
other communications will be sent by notifying the other party via personal delivery, a reputable
overnight carrier or U.S, certified mail-return receipt reques(ed:
TO CITY: TO PI IYSICIAN:
City ofIuntingtonBeach j{owc'.4, 50(-� mi) rl)ox.111S
A71-N: Risk Manager ��10 S ScI)vlye���i�.v.d # 11LA
2000 Main Street
Huntington Beach, CA 92648 �IOo`�S
17. CONSENT.
When CYI'Y's consent/approval is required under this Agreement, its
couseut/apProvol for one tra11S8ction ol•evelit shall )to( be dcumed to be a consent/approval to any
subsequent occurrence of the same or any other (ransacliou ur event.
18. MODIFICATION
No waiver or modification of any language in this Agreement shall be valid unless
in writing and duly executed by both parties.
l9. SECTION H ARTINL S
The titles, captious, section, paragraph and subject headings, and descriptive
phrases at tale beginning of the various sections in this Agreement are merely descriptive and are
inchtded solely Col, convenience of'reference only and are not representative of matters included
or excluded fi'om such provisions, and do not interpret, define, limit or describe, or construe the
intent of the parties or affect the construction or interpretation orally provision of ill is Agreement.
20. JNT'FRPRE'IATION 01 TH[S AGI2P.�M13N'I'
'File language of all parts of this Agreement shall in all cases be construed as a
whole, according to its fair meaning, and not strictly for or against any of the parties. If any
Provision of this Agreement is held by an arbitrator or court of competent jurisdiction to be
unenforceable, void, illegal or invalid, such holding shall not invalidate or affect (lie remaining
covenants find provisions of this Agreement. No covenant or provision shall be deemed dependent
upon any olhc,• unless so expressly provided here. As used in this Agreement, Tile masculine or
uculcr gender and Singular or plural nurllbcr shall be deemed to include (lie other whenever the
context so indicalcs or rcquires. Nothing contained herein shall be construed so as to require the
commission of any act contrary to law, and wherever there is any conflict between any provision
contained herein and any present or future statute, law, ordinance 01' regulation contrary to which
the parties have no right to contract, till;,, the latter shall prevail, and the provision of this
Agreement which is hereby aflected shall be curtailed and limited only to the extent necessary to
bring it within the requireluents of the law.
21. DUPLICATE ORIOINAL
The original of this Agreement and one or nlol-c topics hereto have been prepared
ttud sifrncd lit counterparts a:; duplicate orisinnls, each of which so executed shall, irrespective of
the date of its execution and delivery, be deemed an original. Each duplicate original shall be
deemed an original instrument as against any party who 11m8 signed it.
22. MMIGRATION
PHYSICIAN shall be responsible for full compliance with file immigration and
naturalization laws of the United States and shall, in particular, comply with the provisions of the
United Stales Cocle regarding employment verification.
23. bi-MiA1,SERVICES SUBCONTRACTING PROI11131TED
PHYSICIAN and CITY agree lint CITY is not liable for payment of any
subcontractor work involving legal services, and Thal such legal scrviccs are expressly outside the
scope of services contemplated hereunder, PHYSICIAN understands that pursuant to Ilunrington
Beach 01Y Charley Section 309, (lie City Attorney is the exclusive legal counsel for CITY and
CITY shall not be liable for payment of any legal services expenses incurred by PHYSICIAN.
24. ATTORNEY'S TEES
In the event suit is brought by either party to construe, interpret and/or enforce the
terms and/or provisions of this Agreement or to secure the performance liercof, each party shall
butte its own attorney's fees, such that the prevailing party shall not be entitled to recover its
attorney's fees from the non-prevailing party.
25. SURVIVAL,
Terms and conditions of this Agreement, which by their sense mud context survive
Ilse terminntion of this Agreement, shall so survive.
26. GOVERNING LAW
This Agreement shall be governed and construed in accordance wifli the laws of the
State of California.
27. IMNAT(W S
liacli undersigned represents and warrants that its signature herein below has the
power, authority and right, to hind their respective parties to each of the terms of this Agreement,
and shall indemnify CITY fully for any injuries or damages to CITY in the event that such
authority or power is not, in fact, held by the signatory or is withdrawn,
P11YSICIAN's initials
28. j:El'IR1-TY
"rhe parties acknowledge and agree that they are entering into this Agreement freely
and voluntarily lW10wing extensive aril's length negotiation,and that eacli has had the opportunity
to consult with legal counsel prior to executing this Agreement. The parties also acknowledge and
agree that no representations, inducements, promises,agreements or warranties, oral or otherwise,
have, been wade by that party or anyone acting on that party's behalf, which are not embodied in
this Agr emcnt, and that that party has not executed this Agreement in reliance on any
representalion, inducement, promise, agreement, warranty, filet or circumstance not expressly set
forth in this Agreement. This Agreement, and the attached exhibits, contain the entire agreement
between the parties respecting the subject matter of this Agreement and supersedo all prior
understandings and agreements whether oral or in writing between the parties respecting the
subject matter hereof.
29. EffF,CTIVFDATF
'this Agreement shall be effective on the date of its approval by the City Attorney,
This Agreement shall expire when terminated as provided hereof.
IN WITNESS WFILRFOP, the parties hereto have caused this Agreement to be executed
by and Through their uulhorizcd officw's.
PHYS CLAN
CITY OF HUNTINGTON BEACH, a
o muniri pal corporation of the State of California
7riE/►N arsic7 N' AAI l 1""
Dh c'or of Human Resources —�
APPROVE AS TO FORM:
ttoreyQ0An
Receive and Rile
Ctty Clerk y/�/�
PROFESSIONAL SERVICES CONTRACT Illi'I'WEEN
fHb' CITY OF 1-JUNTJNGTON Bl-,ACI I AND
FOR
INDI-TENDENT M1 D1CA1, I"VALUATONS WITH
RE8PECT'I'0 WORKFIRS' COMPENSATION CLAIMS
'fable of Contents
1 Scopeoi'Services.....................................................................................................1
2 City Staff Assistance................................................................................................2
3 Time of Pul'ormnnce .............................................................................I.,...............2
4 Compcnsation ..........................................................................................................2
5 Extra Work...............................................................................................................2
6 Mclliod ol'Payntent..................................................................................................3
7 Disposition of Plans, Estimates and Othcr Documents ...........................................3
8 Hold 1-Iarmless ................................. .......................................................................3
9 Professional Liability Insurance..............................................................................4
10 Certificates of Insurance..........................................................................................5
11 Independent Conlractrn.............................................................................................5
12 Terminationol'Agreement.......................................................................................6
13 Assignntcot and Suhcontracting ..............................................................................6
14 Copyriglits!Pat ;nis...................................................................................................6
15 City J. mployces and Officials..................................................................................6
16 Notices .....................................................................................................................7
17 Consent ....................................................................................................................7
1SMadificalion.............................................................................................................7
19 Section Iicadings .....................................................................................................8
20 Interpretation of This Agreement...........................................................I......I......,....8
21 Duplicate Original....................................................................................................8
22 Immigration..............................................................................................................9
23 Legal Services Subcontracting Prohibited..................................... .........................9
24 Altorney'S Fccs........................................................................................I.....".....I...9
25 Survival....................................................................................................................9
26 Governing Law ........................................................................................................9
27 Signatories................................................................................................................10
28 Entirety.....................................................................................................................10
29 13ffeclive Datc ..........................................................................................................to
EXT)IIIIT "A"
STATEMENT01 WORK:
1) AOE—COE EXAMS (exams for the determination of industrial causation).
2) Evaluation for necessity of appropriate medical treatment.
3) Assessment. of employee's present ability to return to work, whether lull duty or
modified.
4) Advise on condition of maximum medical improvement status,
5) Determine nature and extent of permanent disability, including factors of apportionmen
and need for future medical care.
G) Resolve utilization review disputes.
7) Determine the need for spinal surgery pursuant to Labor Code section 4062(b).
PHYSICIAN shall perform the evaluation ill fill accordance with the standards defined by the
Division of Workers' Compensation of the State of California and file AMA C3uides to the
Evaluation of Permaucnl Impairment, Biftii Edition. This requires a rcpurt of the igjury, prior
Status, clinical chronology, current Status, and past medical history. The physical examination
will document all portiiient positive, negative, and non-physiological findings, For cxtrcmity
injuries, measurements nufst be documented bilaterally. Additionally, PHYSICIAN agrees to:
(i) provide that medical exams will be set within thirty (30) days of the date of appointment
request, and (ii) prepare a written report of findings within thirly (30) days of the date of exam, or
evaluation and provide a copy to the parties within said time Fume,
EXIIJIBIT "B"
Payment Schedule
I. Missed Appointments
• Pee: $503.75
• Code: M1.200
Apl?Iies when:
• Interpreter does not appear for evaluation.
• Injured worker leaves before con;pletion of the evaluation.
• Cancellation within 6 business days of the scheduled appointment.
2. ('omprehensive Medical-I,el;al F ahtntions
• Fee: $2,015.00
• Code: ML201
Applies to the initial evaluation or the first evaluation in an 18-month period.
The evaluation includes review of up to 200 pages of records.
It must involve an examination of the. employee.
Review of records in excess ol'200 pages is reimbursed at a rate of$3.00 per page.
3. Follow-up Medical-Legal I;valuat.ions
• Fee: $1,316.25
• Codc: ML202
Applies to any subsequent comprehensive evaluation within 18 months of the initial
evaluation.
• This fee includes review of up to 200 pages of records that were not reviewed as part of
the initial evaluation.
• Review of records in excel, cJ'200 pa s (records not reviewed at initial evaluation)
reimbursed at a rate of$3.00 per page.
4. Supplemental Medical-Legal Evaluations
• Fee: $650.00
• Code: \4203
• Does not involve an examination of the patient.
• Results in preparation of a narrative medical report.
Review of records in excess cf 50 pages reimbursed at a rate of$3.00 per page.
i'ees for a supplemental report are not at]owed if:
o Records reviewed were provided to the physician for review before the initial or
follow-up evaluations.
o Supplemental report addresses an issue the patties asked the physician to address
in a prior med-legal evaluations.
5. Medical-Legal Testimony
• I-cc: $455.00 per hour (or physician's usual and customary free, if lower)
• Code: ML204
• Physician is entitled to bill a minimum of 2 hours for deposition.
• If the deposition is canceled within fewer than 8 calendar days prior notice, physician is
entitled to bill 1 hour of time.
6. Medical-Legal Review of Sub Rosa Evidence
• Fee: $325.00 per hour (or physician's usual and customary flee., if lower)
• Code: ML205
• No minimum time allotment.
• Physician must capture time spent reviewing evidence to the nearest quarter-hour.
verified under penalty of perjury.
• The fee does not include production of a medical-legal report. The. tec for time spent
reviewing the recording will be included in the billing, for the initial, follow-up or
supplemental medical- report.
7. Court-Ordered Evaluations
• When a medical-legal evaluation is ordered by a Workers' Compensation 1udgC, the
Judge has authority and discretion to apply the appropriate modifier to that evaluation.
8. The parties agree that the City is not obligated to pay compensation to the I'Fl)'SI(:'IAN
except for agreed upon medical services and care. Failure of PHYSICIAN to provide a
written medical report within 30 days of the date of the exam subjects PI I YSICIAN to non-
payment for services rendered.
9. PHYSICIAN billing shall conform to the requirements listed in section 9795 of Title 8 of
the California Code of Regulations. Charges for Services rendered will be reviewed in
accordance with section 9795 to determine appropriate level of service.
10. City shall pay PHYSICIAN within forly-five (45) days following receipt from
PHYSICIAN of invoices for services rendered and fur which payment has not previously
been made, provided that PHYSICIAN shall submit all invoices within ninety (90) days
after the date of service.
14THEDOCTORSCOMPANY
CERTIFICATE OF INSURANCE Issue Date: 05/17/2021
Effective Date: 07/ol/Ml A Claims-Made Professional Liability Policy
First Named Insured IMPORTANT NOTICE: This document is issued as
Howard L Sofen MD a matter of information and does not confer rights
8930 S Sepulveda Boulevard. Suite 114 to any recipient. This document is not binding, is
Los Angeles, CA 90045 not part of the Policy described below, and does
not change or extend the coverage provided by that
Policy.
Insured: Howard L Sofen MD
Specialty: DER01 -Dermatology
Policy Number: Policy Period:
0032746 From: 07/01/2021 To: 07/01/2022
Retroactive Date: Departure Period:
07/01/1905 From: WA To: WA
The Insured above is: Agency and Address:
❑X A Named Insured The Doctors Company Insurance
❑ A Locum Tenens Services
❑ An Additional Insured 15260 Ventura Boulevard, Suite 200
Sherman Oaks, CA 91403
(800)852.8872
AS TO tom.
LIMITS OF LIABILITY �CKML E.GATW
CrrY Claim Limit: $2,000,000 CITY OF Ml1rinNGTON MA(
Aggregate Limit: $5,000,000
I. Locum Tenens and Additional Insureds share Limits of Liability with the applicable Named Insured.
11. Individuals who occupy a "slot" share Limits of Liability with all others who occupy the same "slot" during the
Policy Period.
III. Photocopies of this document are deemed as valid as the original.
IV. The Policy, including Endorsements, determines the coverage provided. Some Claims may not be covered
by the terms of the Policy, or may be subject to restrictions such as lower Limits of Liability.
V. If the Policy, or coverage for any person, is canceled for any reason or if the terms of the Policy are
changed, we will notify the First Named Insured (and any additional Named Insureds as required by
applicable state law). Coverage is not in effect unless and until all payments are received when due.
VI. If a Departure Period is indicated, the Policy will not respond to Probable Claim Events arising from
Professional Services Incidents or Review Incidents that take place during the designated period; however.
the Policy will respond if we receive a Claim Report during this period.
5
S
MPL003 (04/15) 100 Page 1 of 1 MG02003 33055062-00 Insured
185 Greenwood Road:P.O.Box 2900: Napa.CA 94558-0900:(707)226-0100:(800)421-2368 :www.thedoctors.com